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BCIT Term Spring 2009 Course LIBS 7002 (Applied Ethics) Instructor Brian Thomas Due Date June 17, 2009 Student Arthur Kenzie (A00242330)

“My mother, a dermatologist, told me (without revealing confidential

information) that a young teenager who smoked cigarettes came to her

office with acne. My mother advised her that the acne would not clear up

until she stopped smoking. In truth, only the prescription medication was

needed. My mother said that she was only trying to improve the health of

her patient. Was she right?”

Deception cannot usually be morally justified, but in this case I believe

that the dermatologist mother is on relatively solid ground. The deception

foisted on the young teenage patient was that there is a causal relationship

between smoking and acne. This reminds me of many of the allegorical

stories in the Bible, with the ultimate goal being to change the behaviours

and attitudes of the reader for their own benefit and enlightenment. The

Promised Land of greater health is a worthy goal indeed.

The highly principled will surely rebel idealistically at the falseness of

means, the potential for loss of credibility, the damage to honour and truth.

But even the first formulation of Kant’s categorical imperative could support

the mother’s choice in this matter: “An action is morally right for a person in

a certain situation if, and only if, the person’s reason for carrying out the

action is a reason that she would be willing to have every person act on, in

any similar situation”. Her reason for using deception was, I presume, to

help this young teenager make better choices for herself. She wanted her to

weigh for herself the coolness of smoking against the natural beauty of her

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acne-free skin. Surely, she would want everyone to act with such

consideration and intent.

Kant’s second formulation of his categorical imperative also appears to

me to support the mother’s action: “An action is morally right for a person if,

and only if, in performing the action, the person does not use others merely

as a means for advancing her own interests, but also respects and develops

their capacity to choose freely for themselves”. There are no apparent

motives for the mother to advance her own interests. The young teenager is

her only concern here, both in the specific instance of her skin, and in the

general instance of her health and her improved ability to make choices for

herself.

From what I consider to be a less principled perspective, utilitarianism,

the mother was surely right in her choices. There are considerable net

benefits to helping young teenagers choose not to smoke. On the plus side,

our society as a whole benefits from not having to bear the considerable

financial burden of caring for smokers when they inevitably encounter health

problems caused by their smoking. Second-hand smoke is also reduced,

ensuring that non-smokers are not impacted in the same way as smokers.

Individuals achieve health benefits such as reduced heart, pulmonary, and

respiratory diseases, reduced instances of cancer, and longer life

expectancy. As well, there are individual personal benefits such as improved

senses of taste and smell, more opportunity to save money, greater self-

esteem from being able to resist or conquer addiction to nicotine, and from

setting a better example for children and others.

There are costs to be considered in the utilitarianism analysis, to be

sure. The cost of the deception in terms of lost trust by the young teenager

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for her doctor, and possibly for authority figures in general, could be

considerable. This lost trust could also easily transform into rebellion, which

might extend and amplify the costs such that her future choices may be

driven by a need to do the opposite of what she is being told to do. There is

a cost for the dermatologist mother as well, since she will have to face either

her own guilt, or her compromised personal integrity. Both of these are

slippery slopes, and she will have to guard against using deception on a

regular basis, as opposed to using it for its achievement of greatest benefit

in a specific instance such as this. She will also have to guard against any

increased inclination to be imposing her own views on others at

inappropriate times.

If the patient discovers the deception, or believes it to be an error, and

challenges her dermatologist, then the scenario is altered and different. How

the doctor handles this possibility, and how the doctor follows up on her own

initiative with her patient, are critical moral tests. I would argue, in fact, that

it would be at this time, in these subsequent interactions, that the ethics of

the doctor’s choice would most appropriately be evaluated.

Young teenagers have difficulty making good choices at times. Young

teenage girls who smoke are fairly stereotypical and predictable in our

society, and most would agree that they require a different approach,

different leverage, to get their attention. I believe that there are sufficient

net benefits, as per a utilitarian perspective, to warrant using allegories and

limited deceptions, as the doctor has done in this case, in any attempt to

manage their behaviours and help them learn about themselves. I also

believe that the motives, and perceived duties, of the doctor support the

deontological perspective that she was making the right choice.