• (1) Ways in which normative systems may differ
• (2) Ellin on two approaches to professional morality (priority approach vs. parallel approach)
• (3) Paternalistic deception in medicine
• (4) Is business bluffing ethical

READINGS: Ellin, Special Professional Morality" 130-131; Carr, "Is Business Bluffing Ethical"; Gillespie, "The Business of Ethics"

DIFFERENCES BETWEEN NORMATIVE SYSTEMS THAT ARE MERELY APPARENT

What seems to be a difference really is not
the apparent/alleged “differences” may be deduced from the same principles

• Example #1: Obligation to rescue (professional requirements, ordinary supererogation)
• Example #2: Performing surgery (a professional permission, ordinary prohibition)
• Example #3: Judges and police officers are permitted to limit our freedom

In these cases, the differences seem merely apparent as the same general principles apply across the board
that is, the apparent differences can be explained away by, e.g., pointing to the contractual obligations, the differences in skills etc.
For example, doctors are permitted to cut our bodies but they have a skill they use to help rather than to hurt. Similarly, judges and police officers have a skill they use to help entire society.
Principles do not change, but when applied in different situations (under different conditions) they yield different results.

REAL DIFFERENCES: "NON-CONFLICTS"

EXAMPLE #1: WORSHIP Assume that, in the graph above, the rectangular area on the left represents moral permissions (actions that are morally permissible). (We may think of the red oval as moral obligations and the green oval as moral supererogations.) The blue oval represents religious requirements (actions required from a religious point of view.
This sort of difference is not really a conflict. Religion requires of the agent more than morality. However, religious requirements are in this case requirements to do something morally permissible. We might say that, in this case, religion is stronger than morality, but not in conflict with morality. Worship is morally permissible, but it may be required by religion(s)

EXAMPLE #2: TRUTH TELLING is, in general, (A) legally permissible, but (B) morally required.
This case may be represented by the same graph. We must, assume however, that the area on the left represents legal permissions while the blue oval represents moral requirements.
We might say that, in this case, morality is stronger than law (it requires more than the law). But morality is not in conflict with law, it is legally permissible to fulfil the moral requirement of telling the truth.

EXAMPLE #3: SELF-SACRIFICE

In this graph, green oval represents moral supererogations while blue oval represents religious requirements.

Acts of serious self-sacrifice may be (A) morally supererogatory but (B) required by religion. In this case, religion is stronger than morality, but they are not really in conflict. That is the agent can easily satisfy the requirements of both.

EXAMPLE #4: GIVING FREEDOM TO ONES SUBJECTS
This may be (A) supererogatory in a religious sense (green oval), yet (B) morally required (blue oval)

“MODERATE” CONFLICTS

EXAMPLE 5: DRINKING ALCOHOLIC BEVERAGES The rectangle represents religious permissions and prohibitions, the oval represents moral permissions.

In this case drinking alcoholic beverages (something that seems morally permissible) is prohibited by some religions (e.g., by Islam). It is not a "strong" conflict, for the agent has a choice of doing something that is both morally and religiously permissible. That is, the agent may simply abstain from drinking alcohol.

EXAMPLE 6: DRIVING ABOVE 70 m/h) is morally permissible (if safe) and yet illegal in Texas.

“STRONG” CONFLICTS

EXAMPLE 7: THE EXTERMINATION OF JEWS
The rectangle on the right represents moral prohibitions; the red oval represents legal requirements.
The extermination of Jews is (and was) morally wrong, and yet required by the laws of the Third Reich.
It's the case of "strong" conflict, the agent must chose to obey morality or two obey the (immoral) law and he cannot obey both; there is nothing the agent can do that would fulfill both requirements.

EXAMPLE  8:  HAVING SEX WITH THE "LEADER" The rectangle on the right represents moral and legal prohibitions; the red oval represents requirements adopted by some religious cults.
Sex with the leader is expected /required by some religious cults even if it forces children to do acts that are morally wrong (and also illegal in our society).

EXAMPLE  9: HUMAN SACRIFICES  Required by some cults but morally wrong.

Remember, if some religious system requires of you to act in a way that is immoral and irrational, imost likely, t is a cult.

---

(2) ELLIN ON TWO APPROACHES TO PROFESSIONAL MORALITY

PRIORITY VIEW	PARALLEL VIEW
Ordinary morality and professional morality rest on the same foundations.	Ordinary morality and professional morality rest on the different foundations.
The standards of ordinary reflective morality govern both our typical encounters and all other encounters, including professional encounters.	The standards of ordinary reflective morality govern only our typical (nonprofessional) encounters.
The most general moral principles (e.g., Utilitarianism, Kantian Imperatives, Theories of Rights, Gert's theory, whatever govern all kinds of encounters.	The models of professional behavior govern professional encounters and spell out professional obligations.
The special professional requirements are subordinate to the basic principles of ordinary reflective morality.	The special professional requirements are not subordinate to the basic principles of ordinary reflective morality.
If there are conflicts between professional requirements and the requirements of ordinary morality (only apparent conflicts are possible), they reflect the tension existing within the basic principles.	There are both real and apparent conflicts between professional requirements and the requirements of ordinary morality.
The standards of ordinary reflective morality are used to resolve all apparent conflicts.	In the case of conflict . . . ????????

---

(3)PATERNALISTIC DECEPTION IN MEDICINE

THE DEFINITIONS OF LYING AND DECEPTION ACCORDING TO ELLIN

• A LIE: Any statement which the speaker believes to be false (pp. 131-2).
• A DECEPTION: Either true statements which are nonetheless misleading; or actions which convey a false impression, or the deliberate withholding of information where the person not informed is misled into drawing a false conclusion" (p. 132).

ELLIN ON DECEPTION AND LYING IN ORDINARY MORALITY

• Both lying and deception are generally wrong.
• There is a moral gap between lying and deception; lying is worse than deception.

ELLIN'S REASONS IN SUPPORT OF THE CLAIM THAT LYING IS WORSE THAN DECEPTION

1. The liar takes advantage of weakness more than does the deceiver: "If deception harms the victim's interests in the truth, this harm can occur only if the victim draws an inference grounded on what he has been told... We can defend ourselves against this harm by adopting the following maxim of prudence governing belief: ‘Believe everything you are told but draw no inferences unless supported by independent evidence' (p. 133).
2. The liar is more responsible for the harm caused: "The victim of the lie fails to verify a direct statement, but the victim of deception fails to verify a conclusion of his own" (133)

ELLIN ON DECEPTION AND LYING IN PROFESSIONAL MORALITY

• Lying is still wrong but deception may be permissible.
• It is permissible if it play therapeutic role.

ELLIN'S REASONS FOR THE PERMISSIBILITY OF DECEPTION IN  PROFESSIONAL CONTEXTS

• People enter into a relationship with a medical professional for specific and limited purposes, e.g., to improve their health (p. 136).
• What to tell and how to tell it is determined by purely medical considerations.
• Deception may fulfill the limited purposes for which we enter the relationship; that is, it may promote health.
• Deception does not violate the requirements of professional morality: "professionals are not mandated to protect the client's interests in having true beliefs, in not being manipulated or in being treated with respect... A patient's interests in the truth, for example, is exactly as relevant to the doctor's professional concern as the patient's interest in friends" (136).

ELLIN'S REASONS AGAINST LYING IN PROFESSIONAL CONTEXTS (WHY IS LYING WRONG?)

• "Professionals may have a stronger reasons to tell the truth than ordinary morality implies, because the fiduciary relationship is based on trust" (p. 137).
• Lying may undermine the trust necessary in fiduciary relations.
• So, lying is wrong: "It is probably best if professional morality excluded lying altogether" (136).

ELLIN'S FIDUCIARY MODEL -- THE MAIN TENETS

• A client and a professional are constraint by a special kind of "contract".
• To fulfill her special professional obligations to the clients the professional must ensure that she deserves the trust.
• "In a fiduciary relationship, the professional services the true interests of the client, not the client's immediate wishes or desires" (p. 135). That is, the professional acts in the real (relevant) interest of the client./beneficiary as "he [the professional] alone understands them" (p. 135)
• The nature of their relationship determines what this real (relevant) interest is.
  • "If the relationship is fiduciary, the professional pledges to protect only those interests for the protection of which the relationship exists. One consults the doctor to protect one's health, not one's finances: It is not within the professional competence of a doctor to make judgments about financial matters" (Ellin, p. 135)
  • A patient's interest in the truth . . . is exactly as relevant to the doctor's professional concern as the patient's interest's in friends or leisure: That is, all these interests are relevant to the physician's responsibilities only as they may affect the patient's health" (Ellin, p. 136)

STEF'S COMMENTS:

• It is clear that Ellin's fiduciary model does not require fully informed consent.
• This model allows that the client lack some relevant information (deception is possible).
• Hence, it allows that the client is treated despite of the fact he/she did not give fully informed consent to this treatment.

COLLINS AND BOK ON PATERNALISTIC DECEPTION

BASIC CONCEPTUAL ISSUES

COLLINS: He seems to neglect conceptual differences between lying and deception.
Doctors frequently "withhold the truth from their patients, which is tantamount to telling them a lie" (139).

BOK: "I shall define as a lie any intentionally deceptive message which is stated... Deception, then is the larger category, and lying forms part of it" (141-2).

MORAL ASPECTS

COLLINS: Doctors ought to deceive.

• The art of medicine consists in skillfully mixing falsehood and truth (p. 139).
• The longer I practice medicine the more I am convinced that every physician should cultivate lying as a fine art (p. 140).
• Deception is good for the patients.
• Most patients do not need to know the truth.
• Most are incapable of receiving the truth.
• Practically no patient wants to know the truth (140).
• The truth might injure them (140).

BOK:

• A fundamental ‘default' position is that we must tell the truth. There is the general obligation of veracity and general presumption against lying and deception.
• From the patient's perspective:
  The respect for autonomy requires that patients give informed consent.
  Informed consent requires to reveal all the relevant information (147).
  Patient must know what the procedures are and what they are supposed to correct.

THREE MAIN ARGUMENTS FOR LYING (REJECTED BY BOK)

TRUTHFULNESS IS IMPOSSIBLE: Bok's reply (not in the book): The ‘absolute' truthfulness may be impossible. But in general (almost always in real life situations) we can tell the truth. So, the default position requires that the professional tell the truth.

PATIENTS DO NOT REALLY WANT INFORMATION: Bok's reply: Empirical studies show that about 80% of the persons want to know the truth.
Only some patients go through the process of denial. Only about 25% of the patients give any evidence of denial

TRUTHFUL INFORMATION HARMS THE PATIENTS: Bok's reply: In fact, when patients know the truth they better tolerate pain; their recovery from surgery is quicker, and their cooperation with therapy is improved (p. 147, 148)

THE SUMMARY OF VIEWS ABOUT DECEPTION AND LYING

	ELLIN	COLLINS	BOK
Is there a conceptual difference between lying and deception?	YES	NO	YES
Is lying generally wrong from the point of view of ordinary reflective morality?	YES	??? (does not address the issue)	YES
Is deception generally wrong from the point of view of ordinary reflective morality?	YES	???	YES
Is lying worse than deception from the point of view of ordinary reflective morality?	YES	???	???
Is lying generally wrong from the point of view of professional morality?	YES	NO	YES
Is deception generally wrong from the point of view of professional morality?	NO	NO	YES
Is lying worse than deception from the point of view of professional reflective morality?	YES	NO	NO

---

(4) IS BUSINESS BLUFFING ETHICAL?

CARR CLAIMS THAT THE FOLLOWING ACTIONS/PRACTICES ARE PERMISSIBLE

• Deceiving during business negotiations. "Most executives from time to time are almost compelled, in the interests of their companies or themselves, to practice some form of deception when negotiating with customers, dealers, labor unions, government officials, or even other departments of their companies" (p. 69).
• Lying about one's reading preferences and one's age if doing otherwise will prevent you from getting a job (p. 70).
• Engaging in industrial espionage (pp. 70-71).
• Contributing to the election fund of a candidate one is opposing if doing otherwise will prevent you from getting the business order (pp. 71-72).
• Selling a popular mouthwash with a possibly deleterious form of alcohol.
• Selling master automobile keys through the mail orders to potential criminals.

CARR'S MAIN POINTS SEEM TO BE

• ‘Church' (i.e. standard, ordinary, normal) morality does not apply to business.
• "No one expects poker to be played on the ethical principles preached in churches... Poker's own brand of ethics is different from the ethical ideals of civilized human relationships" (p. 70A)
• “Poker's own brand of ethics is different from the ethical ideals of civilized human relationships” (p. 70B).

CARR'S REASONS IN SUPPORT OF HIS POSITION

1) In all relevant respects, the practice of business is just like the game of poker and bluffing and deception are OK in poker. (pp. 70, 72)

2) If a business practice is not illegal, it is thereby ethically acceptable and permissible:

• "So long as a businessman complies with the laws of the land and avoids telling malicious lies, he's ethical" (p. 70, quoting Robins).
• "The basic rules of the game [of business] have been set by the government, which attempts to detect and punish business frauds. But as long as a company does not transgress the rules of the game set by law, it has the legal right to shape its strategy without reference to anything but its profits... decisions in this area are, in the final test, decisions of strategy, not of ethics... (p. 71)

3) Everybody does it; if a practice is widely spread, then it does not violate any moral prohibition.

• "Espionage in business is not an ethical problem; it's an established technique of business competition" (p. 71, quote from Robbins).

GILLESPIE DISCUSSES EACH OF THESE REASONS

At 2) If a business practice is not illegal, it is thereby ethically acceptable and permissible:

• This sort of reason confuses law with morality
• Moral questions cannot be answered by simply addressing legal issues
• There are numerous examples of legal practices that are morally wrong

At 3) Everybody does it; if a practice is widely spread, then it does not violate any moral prohibition.

• That everybody does it, shows very little about normative issues, it show nothing about what ought to be the case

At 1) Although it may be a fact that business is frequently conducted like the game of poker, there are important dissimilarities between these two.

POKER	BUSINESS
usually, stakes are relatively low	stakes are frequently high
typically, people know the risks and their chances	frequently, we do not know the risks and chances
they are free to play or not to play	frequently, we have no choice to play or not to play
they give an inform consent when they play	elements of coercion and/or manipulation are present

A POSSIBLE GENERAL REASON  IN SUPPORT OF CARRS POSITION

 Someone like Carr may accept, perhaps, a "simple" view about morality. On this view morality is a system of extremely simple rules that admit to few (if any) exceptions; e.g.:

• “Lying is wrong, period!”
• “Do not deceive, no matter what.”

These rules govern our actions on some contexts and areas;

If morality is a system of such rules, however, several questions arise:

• Can rules of this sort be universally valid? Do they apply in all situations?
• In particular, do they apply in business contexts?

Carr (and others) would say “No!” There is no doubts that rules of this sort are too simple to govern encounters in many contexts we encounter. Carr, in particular, thinks that they cannot govern our business relations.

Hence he seems to opt for what may be called the "separation view" about morality

To wit, Carr seems to postulate that

• moral rules govern only some areas, e.g., family relations and relations between friends, etc.
• they do not apply to business
• different rules govern business transactions.

But this postulate also has problems:

• Why do we single single out business?
• Why not to accept further divisions?

• How would we decide about these divisions?
• Carr does not give any answer to these questions

A SOPHISTICATED SYSTEMATIC VIEW ABOUT MORALITY

The "separation" view about morality is not the only alternative to the "simple" view.

According to sophisticated/systematic view about morality:

• morality is a set of fairly complex rules
• these rules admit to several sorts of exceptions
• moral behavior in all areas is governed by moral rules
• moral rules have the following form: “Lying is wrong, except if __________, ” “Do not deceive, except if __________.”
• exceptions may be hard to discover
• we decide about them in a systematic (not “ad hoc”) way

IMPLICATIONS FOR BUSINESS

• Some business practices are covered by the exceptions to moral rules.
• Certain forms of business practices are not covered by these exceptions.
• Carr is correct that some forms of deception in business are morally right.
• He is also wrong; many forms of deception in business are morally wrong (even if they are legal).

GILLESPIE ON THREE SORTS OF EXCEPTIONS

• A conflict between moral considerations
  Moral costs of doing something may sometimes be too high. (A prohibition against lying may be in conflict with a requirement to protect life.)
• Aa conflict between moral considerations and the requirements of prudence.
  Personal costs of doing something may be too high. E.g., you damage someone's property to protect your life.

The background conditions constrain what can be meaningfully done 
The morally desirable state of affairs can be produced only by everyone, or virtually everyone, doing his or her part. If only one individual did his part, his or her act would have virtually no positive impact and his or her effort would be wasted.

Professional Ethics