And then there is Prudence. Truth comes with Prudence, the acting on information. 

Trying to be a backseat driver is not a good habit. I believe that the Doctor did was right. The Doctor practiced prudence. Another thing, Doctors are very busy. Second, Doctors ain't god. They are humans. The Doctor did approach Tony with prudence in "easing" the patient to a course of events. We can NOT know every particular in a patient especially in psychology department. There one has to be telepathic, god, and omniscient. No human is that way. If the Doctor was Jesus Christ, it would still be hard to do it. 

I don't know Tony's case if it was genetics, or his diet, or his lack of exercise, or a combination of those things but two of those later things is Tony's fault. He may have brought that all on himself.  So don't go complaining about the doctor who didn't quite get it right. If you are worried that he was close to death due to the Doctor---Methinks Tony has the greater responsibility if it was a lack of exercise and or his unhealthy eating habits. 

I would emphasize how in any actual case, the doctor does not have the knowledge in question. No one has such detailed knowledge, which licenses such predictions, of another person's body and psychology. In assessing the case, we should not lose sight of just how much knowledge we are being asked to imagine the doctor having.

My first response is that the doctor should be especially careful in passing on the information to Tony. Again, in any normal case where one knew someone were prone to, say, panic in threatening situations and heart attacks as a result, this would be all that the doctor would be committed to; there's no normal case in which a doctor can think it likely that there is no way to inform his patient of his condition.

It may be replied that this is not a normal case. Not only does the doctor know that the usual way of informing Tony would cause Tony to have a heart attack. He knows that every way of informing Tony would cause a heart attack. This is an even more extreme possibility we are being asked to imagine, I observe.

Clearly this is a world very different from our own. How does the doctor know this? They must have very impressive medical technology. Presumably their technology is good enough that a doctor could have a team on standby to revive Tony, since the doctor is, we are imagining, certain that the heart attack will result.

Or perhaps, since this world is so different from ours, hospitals have different policies. If this sort of situation could arise, and the doctors have genuine certainty, then it might be reasonable for hospitals simply to have the means at hand to knock patients out so they can perform the surgery removing the threatening condition, without the patient ever learning of their risk. This wouldn't be intrinsically immoral. We would worry about paternalism. But this is a world in which medical science is so advanced that the concern might not be warranted.

In any case, the doctor shouldn't lie to Tony. It is incorrect that Tony lacked the ability to know the truth; indeed he had to know the truth if knowing the truth was to cause his heart attack.

Johannes wrote:

Greg, the point is not "How does the doctor know this?", but "Assuming that he knows it, what would be the right course of action for him?"

Yes, I assumed that he knows it, and drew various inferences about what sort of world he must live in if that hypothesis is to be true, so that I could decide what sort of actions he might take.

The Orthodox theologian and philospher, Apostolos Makrakis, had a better definition of truth, short and quick. Definitions need to be short and quick. The one proposed is too long, complicated. 

Makrakis said, "Truth is the faithful representation of reality". Simple. Quick. Thorough. And the definition doesn't rely on second or third parties. It defines it to itself. Res ipsa loquitur ("The thing itself speaks")
Next, the idea of the "greater good" is directed to natural organic groups such as racial clans, tribes, nations. That is where the "greater good" exists. It doesn't exist in the medical office. The practice of medicine is in the Business field. There is a doctor, and a patient. What is entailed here is Business ethics, first, medical ethics second, and then bedside manner. This has nothing to do with the "greater good". Bedside manners is a very large and difficult field and is quite subjective, I would think. Not everybody has the grace or eloquence of a refined psychological speaker. 

I'll try to clarify the case which I presented as the starting point for discussion.

First, the hypothetical case does not pressupose a different world than the one we live in. In this world, it is wholly possible that a person D (Doctor) knows the psychology of a person T (Tony) without D having mind-reading powers. Rather, it may be the case that D is a direct acquaintance of T, or that D knows T's psychology indirectly, through a common acquaintance. And it may be the case that T is well-known among his acquaintances for not having precisely a cold, calm personality.

Therefore, it is wholly possible that a normal person D in this world, when he has all the pieces, is able to put them together and infer:

T's cardiovascular state + T's psychological profile + T's learning about his state = highly probable heart attack.

The second assumption, namely that D was able to put all the pieces together only when he entered T's room and was asked by him "Hi, Doctor, I'm feeling fine now, so I guess I can go home. What have the studies found?", is also wholly possible. E.g., it may be the case that D, not being the doctor who had conducted the study and had written the report, was learning of its contents at that very moment, or that D recognized T only when he saw him ("Oh, it's that guy"!).

At that moment the Doctor, having just put all the pieces together, has before him 2 options:

1. Avoid placing Tony's life at risk

He answers: "There doesn't seem to be anything serious, although you should quit smoking. But we need to make an additional study to be sure, and you'll have to take a couple of pills in preparation for that study." And he gives Tony a vasodilator plus an anxiolitic (or whatever pills are suitable to condition Tony's heart and mind to receive the news without risk of a heart attack). An hour later, when the pills have made their effect, he enters Tony's room again and tells him: "Actually, your cardiovascular state is extremely delicate and requires urgent bypass surgery, which we will perform tomorrow."

2. Let the truth be told though the heavens fall

He answers: "Your cardiovascular state is extremely delicate and requires urgent bypass surgery, which we will perform tomorrow."

Now, those who hold the basic (*) definitions of truthfulness and lie will say that the double lie by the Doctor in option 1, namely that Tony's condition was not very serious and that the two pills were to prepare him for a further study, was a venial sin, and that the optimal course of action from the moral viewpoint was 2.

(*) By "basic" I mean the definitions of truthfulness and lie that disregard any consideration of the capacity of the receiver of the information to process it in a way which is conducive to the greater good.

As a last note, it is clear that this discussion does not apply to truths about God and his designs for us, but only to purely temporal truths. Telling faithfully the truth about God and his designs is always conducive to the greater good, for any person in any circumstance.

Last edited by Johannes (2/23/2018 2:04 pm)