Casuists and moral theologians have always been interested in the places where medical, legal, and ethical problems meet. But with the increased specialization of university philosophers and the overwhelming interest in formal problems, modern philosophy has not, at least until recently, made much direct contribution to the solution of the moral problems that arise in practice for politicians, lawyers, physicians, and ordinary people tangled up in the network of their necessary relations with the members of these professions. There are many signs of change, and Dr. Bok’s book, together with the periodical Philosophy and Public Affairs and the work done at the Hastings Center, is one of the most notable. It is pleasant to find a work of such analytical power devoted to a set of severely practical problems and to find it so well written. It is hard to write on such topics without falling into the jargon (and with the jargon the intellectual corruption) that makes so much writing in England on social topics messy and repellent. It is also refreshing, and uncommon, to find a contemporary philosopher who is prepared to consider as possibly usable the resources of the entire philosophical tradition. She has an appendix with samples of what philosophers have said on the topics of lying and truthtelling, and the range is from Augustine to G.J. Warnock, with Aquinas, Grotius, Kant, Sidgwick, and others coming in between.

That veracity is a virtue seems one of the most persuasive theses in morality. It may be treated as a particular showing of a more comprehensive virtue, that of justice; but there is about veracity no suspicion of the kind which has made men from time to time hesitate about some of the other traditional virtues. Courage may be puzzled over; and what counts as courage may vary from time to time and place to place; humility and chastity have sometimes been termed, pejoratively, monkish virtues, that is, not really virtues at all. That practical wisdom—prudence—is properly to be called a virtue is a disputed position in philosophy. But the habit of truthtelling, an acquired disposition to speak the truth even in situations where something else we value could be safeguarded, as we suppose at the time, by a lie, this seems quite straightforwardly a virtue and what binds together any tolerable society.

After all, truthtelling has to be the norm; if it isn’t, language, considered as nonfictive communication, stumbles and collapses. And since language may fairly enough be thought constitutive of human nature, the most evident sign of the rationality believed to set man apart from other animals, lying resembles spiritual suicide. Truthtelling seems so necessary a virtue that it has been tied to peaceableness, and the disposition to observe the Golden Rule, as a part of the comprehensive virtue of civility. Hobbes thought metaphor a dangerous trope, calculated to deceive, tolerable only as a pedagogic device to startle the mind. Novels and other fictions have often been looked upon with some suspicion as perhaps being curious forms of lying. In a now forgotten novel a Scottish Presbyterian minister is made to describe the Scott monument in Edinburgh as a monument to “the Great Liar” and this perhaps represents a common attitude among the more severe Protestants in the nineteenth century.

At the very least, it is wise to be nervous about any modes of discourse that seem to treat truthtelling lightly and beguile the unwary into thinking the thing that is not. As Mrs. Bok reminds us, it was possible for the conscientious parents of Edmund Gosse to keep from him the entire body of imaginative literature directed to children. “Never, in all my early childhood, did anyone address to me the affecting preamble ‘Once upon a time!”‘ In such instances of savage deprivation it is evident on reflection that the question of veracity is not aptly raised. To suppose that fictions are lies rests upon a mistake in analysis, though it was Bertrand Russell who thought the sense of “The present king of France is bald” (uttered when France was living under the Third Republic) could be saved only by analyzing it into a false statement.

Whether or not truth will prevail is another question. But if there are to be stable families, brotherhoods, associations, political communities, then, it seems evident, truth must be counted a virtue, liars despised.

At just this point we may suddenly begin to wonder how defensible, in theory or in practice, the general duty of truthtelling really is; we may even wonder, and thus toy with a thesis directly counter to the one we have so far taken to be adequate, if lying is not so much a part of social life, from the family to the state, that a burst of truthtelling would wreck our institutions and produce vast unhappiness.

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There is first the great company of white lies. In the old days, a lady who did not wish to see a visitor would instruct her servant to say she was “not at home.” This did not succeed as a lie, for the caller was not deceived; but feelings were spared, though why they were not wounded is a curious matter. Why do we find words that are fair and false, and known to be false, more gratifying and less disturbing than the open truth? That we do find them so seems obvious. The “yours sincerely” or “cordially,” even, in the nineteenth century, “affectionately,” in the subscription to a letter softens the roughness of social relations; only a precisian, we feel, would find his conscientious judgment troubled over such matters. The once common subscription, “your most obedient and humble servant,” seems rare now, not perhaps because it was commonly a lie but because it seems to go with models of deferential behavior that most of us now find irritating. Again, to say to an acquaintance that one is very glad to see him or to reassure someone who is ill that he is looking better, these seem harmless acts where what is said is not strictly true.

Sissela Bok points out that a good deal of lying that goes rather beyond the region of white lying is nevertheless grouped with it. Such are:

the lies told on the spur of the moment, for want of reflection, or to get out of a scrape, or even simply to pass the time,…the lies told to boast or exaggerate, or on the contrary to deprecate and understate; the many lies told or repeated in gossip; Rousseau’s lies told “simply in order to say something”; the embroidering on facts that seem too tedious in their own right; and the substitution of a quick lie for the lengthy explanations one might otherwise have to provide for something not worth spending time on.

Taken individually members of these classes of lie can usually be justified by a calculation of advantages against costs; and it may seem humorless to object to them as we might object to lying in serious matters, though the multiplication and exaggeration of the good stories repeated in gossip may sometimes bring us up rather short. But Bok is able to show that moral practice has a kind of continuity of development that may imperceptibly and little by little lead us to accept practices that look dangerous on reflection. The prescribing of placebos to unwitting patients is full of unforeseen difficulties; and “deception by placebo can spread from therapy and diagnosis to experimentation.” That there can be a slide from sugar pills to less harmless medicaments seems plain, and the same sophistical justifications may be advanced by physicians: the patients are too ignorant, or too stupid, or too emotionally disturbed, or potentially litigious. Or it may be maintained—this is a revelation for which one is grateful to Dr. Bok—that nobody really knows just what the truth is in any matter (words fail us, as we say), and that therefore, since we can’t in any case speak the truth, there is no harm in lying. It seems plausible to suppose that a habit of lying in small matters and the institution of beneficent lying may so captivate us that we in the end find ourselves with such wild sophistries in our mouths.

Lying in public life excites little surprise, and indignation before the spectacle of it seems often feigned, since those who denounce politicians and administrators and secret policemen are often liars themselves. To lie for one’s country may seem a duty of patriotism and to tell the truth may be thought treachery. When in the legislature a man says that such-and-such an action of the government is, say, “the most disgraceful action in the history of the country,” we don’t suppose this is what he believes. It seems a good thing to say; if it is formally a lie it is notably unsuccessful. Lying to save the credit of a colleague or of a regime is often thought meritorious.

All the same, even those who lie without shame are happier if they can produce a form of words that is equivocal, or strictly true, though not in the sense in which it is likely to be taken, or true in part, or not a direct lie but an evasion. We may be committed to theories that require us to say things that we know, if we reflect, to be false or unlikely. Political ideologues, and no doubt ideologues of other kinds, are given to lies of this kind. A little old lady who really was wearing tennis shoes once informed me that the then president (Eisenhower) was the top communist agent in the United States. Perhaps she was the victim of the lies of others and really thought this was true. Perhaps many anti-Semites and vulgar Marxists do believe the queer things they say and have been deceived by the lies of their superiors. In Europe it is not uncommon to find young men, even in universities, who will explain to cheering audiences that black people in the United States have no legal rights. Anti-Semites will explain that the hostility between the Western powers and the Soviet Union is a comedy arranged by the Jewish masters of Moscow and Washington. The falseness of such statements is so enormous that we are inclined to say that those who make them must be sick. Perhaps many of them are, but not all. Streicher may well have believed his loathsome fables, but it seems unlikely that Goebbels did. If political life is extremely decadent we may reach the point at which the language of politics may be such that the truth cannot be formulated, as with Orwell’s Newspeak.

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On the whole, Sissela Bok stays away from the bizarre. Her central concerns are not so much with all forms of voluntary deception as with the current attitudes and practices of the professions, and especially with those of the medical profession. The relations between doctors and patients, and between doctors and the public, have always presented interesting material for the casuist; but, as she is able to show, the immense advances in medicine, and the new possibilities of successful experimentation, have raised a multitude of difficult moral problems that are in general not steadily faced but are considered individually, with little attempt to work through them in a systematic way. Given the immense importance of the practice of medicine in the opulent societies, the devotion to it of technical resources and scientific speculation, the extent to which the climactic events of birth and death are encountered in the setting of the hospital and not the home, the amount of the social income consecrated to drugs, painkillers, surgery (therapeutic and cosmetic), contraceptives, and abortions, confusion—if it exists—over the moral ground rules of the medical profession is a matter of proper public concern.

There is some evidence, perhaps anecdotal for the most part but not altogether to be set aside, that the ethos of many middle-aged and elderly physicians puzzles some of the young. A Canadian professor speaking to students on medical ethics found some of them incredulous when he told them that they ought not to sleep with their female patients. Here is a prohibition with an obvious rationale, evident without much reflection; if its obviousness is missed, it seems likely that the more obscure moral problems connected with truthtelling between doctors and patients will be solved in a merely intuitive and unreflective way.

When lying is common and expected we lose our bearings in the world. This may happen precisely in those circumstances where lying seems to be eminently justified. Bok quotes the noble-sounding words of James Martineau:

On the area of every human society, and mixed with its throngs, there are always some who are thus in it but not of it, who are there, not to serve it, but to prey upon it, to use its order for the impunity of disorder, and wrest its rights into opportunities of wrong. Assassins, robbers, enemies with arms in their hands, madmen beyond the pale…. Without a certain moral consensus the commonwealth of truth cannot be constituted, and cannot be entered.

From this position (Bok argues) it is possible to infer that those who stand outside the commonwealth of truth have no right to the truth. “Armed with such a conviction, those who contemplate action against enemies may then throw ordinary moral inquiry to the winds. They see no reason to seek alternatives to lying…[but] all the dangers from indiscriminate lying and corruption of power are increased when one’s low opinion of the dupes seems to justify one’s lies.” Political life, and especially relations between states, illustrates the force of this argument. This is not simply a question of the monstrous lies by which totalitarian societies live. “Life is becoming more joyful,” Stalin cried, at just that moment in Soviet history when there was want in the towns and the countryside and more and more innocents were being sent to arctic camps and to the dungeons of the political police. “Czechoslovakia is a dagger pointing at the heart of the Reich,” complained Hitler, at the moment when he knew Britain and France were prepared with threats and anaesthetics to deliver the Czech Republic into his hands. But free societies faced with those they take to be their enemies, or thinking some great good may be had if a few lies are told, are complacent before the falsehoods of their governments. Of the many proferred examples of the lying of democratic governments the conduct of Johnson’s campaign in the course of the 1964 presidential election campaign is one of the most interesting.

Johnson’s fundamental argument, and a successful one, was that he was the candidate of peace, Goldwater the man who would plunge the United States more deeply into the Vietnam adventure and thus endanger the peace of the world: “the only real issue in this campaign, the only thing you ought to be concerned about at all, is: Who can best keep the peace?” But in fact Johnson’s policy was a feint. A State Department memorandum ran as follows (this was September 1964, just before the election):

During the next two months, because of the lack of “rebuttal time” before the election to justify particular actions which may be distorted to the US public, we must act with special care—signaling to [the South Vietnamese] that we are behaving energetically despite the restraints of our political season, and to the U.S. public that we are behaving with good purpose and restraint.

Operation Rolling Thunder was begun early in 1965.

Of course, we might well admit that this was by no means a plainly monstrous deception for which no good reasons could be given. On the contrary, the arguments, as summarized by Dr. Bok, may seem persuasive.

To be forthright about the likelihood of escalation might lose many votes; it certainly could not fit with the campaign to portray President Johnson as the candidate most likely to keep the peace. Second, the government feared that its explanations might be “distorted” in the election campaign, so that the voters would not have the correct information before them. Third, time was lacking for the government to make an effort at educating the people about all that was at issue. Finally, the plans were not definitive; changes were possible, and the Vietnamese situation itself very unstable. For all these reasons, it seemed best to campaign for negotiation and restraint and let the Republican opponent be the target for the fear of United States belligerence.

All the same, Dr. Bok is surely right in saying that such deception worsens the quality and may even imperil the existence of democratic government.

Deceiving the people for the sake of the people is a self-contradictory notion in a democracy, unless it can be shown that there has been genuine consent to deceit. The actions of President Johnson were therefore inconsistent with the most basic principle of our democratic system.

In the end, Johnson, who at the beginning had, as they say, everything going for him, was compelled to leave public life. People grew tired of the lies and half-truths of their political and military leaders. Dr. Bok asks the right question. “Do we want to live in a society where public officials can resort to deceit and manipulation whenever they decide that an exceptional crisis has arisen?”

But why should anyone go on about lying for a whole book? We don’t write books to show that killing the innocent or torturing anyone is wrong. Those who don’t already hold such moral platitudes are unlikely to be turned around even at book-length. We need Dr. Bok’s book because a great many people, who would be ashamed openly to justify killing the innocent or torturing prisoners, think lying is no great harm, unless, of course, they themselves are threatened by some monstrous libel. Physicians, in particular, as Dr. Bok is able to show, in general treat truth roughly and have good consciences about the deceptions they practice. Many of them are now coming to doubt the doctor’s right to lie to his patient, and Lying may convert some more. It is after all clear, to put the matter at its lowest, that if physicians are known to lie to patients about their conditions they will not be believed when what they say is true, when for instance they say that the tumor is benign; and it is true that it is benign.

Can we escape from the kingdom of the lie, short of the Parousia or the realization of utopia? Wollaston, the eighteenth-century moralist, argued that all forms of wrong-doing are really lies, and that the lie is therefore the common sin of all mankind. Adultery: this is to declare that my paramour is my wife/husband; Theft: this is to declare that what I steal from another is mine; Murder: this is to claim that I am God, the master of life and death; I dolatry: this is to declare that this bit of wood or stone is God. And so on. This won’t do as a theory but it relies upon a common disposition of most men, or perhaps all men on occasion, to make the world, by word or act, other than in fact it is.

Think, for example, of the careful industry that goes into the denial of middle age and old age, an industry that goes beyond life to death, with the stuffing and painting of the dead, as though they were so many pharaohs, each body ready for some apotheosis. The whole cosmetic industry, for the quick and the dead, is designed to enable people to be deceptive about their ages and their native complexions and hair colors. There are corsets to make the fat look slim, brassieres to make the slack-breasted firm, fluids to made the brunette blond, techniques for making the straight-haired curly and the curly straight. There are credit cards which, it is suggested, will make us look important and rich, even if we are neither. We sit in front of plastic instrument panels got up to look like wood; our bathroom floors are covered with sheets of artificial marble; we put synthetic cream and sugar into our coffee—each looks like the real thing, so it is necessary to state on the packet that what is inside it isn’t what it seems to be. This last seems a touch of virtue, but it is probably a hedge against litigation.

Not that there is anything especially mendacious about our civilization; it is simply that technical ingenuity has revealed more and greater possibilities. Hypocrisy, deceit, falseness to one’s word, self-deception, the treachery of appearances…these have always been the staple of human life, as playwrights and novelists have known very well. But there are those for whom mendacity is a deeper wound, a heavier fall, than for others. Such are the professions, medicine, the law, scholarship, and teaching. For these the practice of lying is more wounding than for, say, those who live by the market or who get their living by entertaining the public. It is good that these latter should tell the truth; but if the former fall into mendacity they have destroyed the substance of their lives and made their professions useless for their formal purposes.

There is a further problem about which Dr. Bok does have something to say but about which more could be said. She gives the instance I have already noted, that of the doctor who defends lying on the ground that it is impossible ever adequately to speak the truth: situations are too complicated, predictions are always uncertain, diagnoses may be mistaken. Commonly such arguments are sophistical. Nevertheless, there are some situations in which we don’t know how to apply the concept of truth. This is often how it is when we try to explain or give an account of our feelings and of certain of our states of mind. We may find the truth of our feelings expressed in poetry or music or painting or the dance; we may express our states of mind in parables, in what Kierkegaard called indirect teaching.

In such connections the concept of truth is often pushed aside by other concepts, the banal concept of sincerity, the once fashionable concept of authenticity. I think we should not give up so easily on truth in such matters, though it isn’t always clear how we are to speak the truth. Again, we now take for granted that much behavior, including verbal behavior, is such that the description offered by the actor is different from that given by the shrewd observer. Compulsive hand-washing may be for the neurotic a perpetual attempt to get rid of physical dirt; to the observer the significance is quite different. It is not that the neurotic is lying or intends to deceive. This has always been known by some. Shakespeare makes Lear in a moment of madness and illumination cry out

Thou rascal beadle, hold thy bloody hand!
Why dost thou lash that whore? Strip thy own back,
Thou hotly lusts to use her in that kind
For which thou whip’st her.

That behavior is not always what it seems to the actor was known to Plato, and he finds that in men which spurs them to strange actions betrayed in dreams (Republic IX 571). Not everything in us is open to a cool inspection. In such matters truth is an achievement, not something that lies immediately within our power. Sometimes our self-deceptions are deep and beyond the possibility of any knowledge that lies readily to hand. Perhaps Dr. Bok will give us a book on self-deception. She is admirably equipped to write it.

This Issue

June 1, 1978