A doctor withholds a terminal diagnosis from a patient to spare them the loss of hope. What does duty ethics say, and why?
Not permitted — for Kant the prohibition on deception is absolute, and withholding here is deception by omission that strips the patient of the ability to decide about their own remaining life.
Two separate arguments, and it is worth keeping them apart because only the second generalises well:
- The absolute prohibition on deception. For Kant, deceiving is forbidden without exception. Staying silent is, in this case, a form of deception by omission — the doctor is not merely failing to volunteer something; they are deliberately maintaining a false belief. The kindly motive is irrelevant to the classification.
- The autonomy of the person. Kant demands that human beings never be treated merely as a means, but always also as an end in themselves. By withholding the truth, the doctor takes from the patient the chance to make self-determined decisions about the rest of their life — arranging a will, reconciling with someone, saying goodbye. The doctor has decided, on the patient's behalf, what the patient can handle.
The second argument is the one that carries the weight, and it explains why modern medical ethics reaches the same conclusion by a different route: informed consent and the duty of disclosure exist precisely because a patient who is not told cannot decide. Note that the conclusion does not depend on the outcome being bad. Even if the deception demonstrably produced a happier final month, it would still treat the patient as an object of management rather than as an author of their own life — and that is what the theory forbids.
Go deeper:
Stanford Encyclopedia: Informed Consent — how modern medical ethics reaches the same verdict by the autonomy route rather than the anti-deception one.- Wikipedia: Categorical imperative — the Formula of Humanity — »never merely as a means« — in its original setting.