Paternalistic deception is a type of deception that is ostensibly performed for the deceived individual's good by a person assuming a paternalistic role, whether they are their actual parent or not. [1] The most used form of paternalistic deception are paternalist lies. [2] They are told by an individual, a group, or an institution with the intent of benefitting the target lied to by sparing their feelings or preventing them from experiencing psychological harm. [3] As they are justified by the assumption that they are in the target's best interest, they are a subset of prosocial lies. [4] They can occur through omissions, half-truths, or white lies. [2] Paternalistic lies can be manipulative, [5] however their key feature involves the interference with the target's autonomy. [5] This is induced by denying them access to accurate information [6] and by limiting their behaviour choices. [5] Confrontations with paternalistic lies can begin in early childhood and continue throughout an individual's life. [2]
Paternalistic lies are rooted in subjective assumptions, which can solely predict the target's preferences. [4] Several studies show that targets judge paternalistic lies harshly because they perceive their autonomy to have been violated. [4] The underlying reason is the belief in the right to know the truth. [4] Instead, targets see paternalistic lies as an attempt to influence or coerce them through trust, as they may not have chosen the outcome for themselves [4] or to impose an assumed superior framework of the world to the reality shaped by the truth. The lie-teller always overestimates beneficial aspects and minimizes the potential harm of the lie, resulting in a more favourable attitude. [4] Targets, however, end up questioning the underlying benevolent intentions of the lie-teller because of the liars' subjective judgements and the consequent interference with their autonomy. [4]
Moreover, if the deceived individual discovers they have been lied to, it can induce emotional responses such as mild disappointment, hurt, anger, or complete betrayal. [6] Since paternalistic liars are perceived as inaccurately predicting the target's preferences, this can lead to reactance such as the derogation of the deceiver or a decrease in the outcomes' attractiveness due to the nature of it being a lie. [4] The target can shift their preferences, as the process of being lied to becomes more important than the outcome itself. [4]
The responses to lies depend on the desirability of outcomes and the perceived fairness by which those outcomes are obtained. If outcomes are desirable, targets will respond favourably regardless of the fairness in the process involved. [4] However, if the outcome is undesirable, their response will account for the unfairness in the outcome's process. [4] Since paternalistic lies are not objectively desirable compared to honesty, the targets will be less satisfied with the resulting outcome than when the same outcome is obtained via honesty. [4]
Lie-tellers are also affected by the lie. They establish an ego-protective mechanism that generates a normalization belief through comparison to equally blameworthy activities by others to try and minimize their self-discrepancy. [7] This can be traced back to the conflict between internal values, such as protecting loved ones, and social norms around truth-telling. [7]
Besides, studies have shown that people who have been intensely or often lied to tend to increase their frequency of deception. [8] This finding is in line with the negative reciprocity norm, as it involves a set of beliefs favouring retribution as a counteract to being unfavourably treated. [8] This implies that people reciprocate equally when receiving negative treatment. [8]
Parents are the key figures children rely on in their developmental years. [2] They represent their role models, which greatly influence and ground their social learning. [9] Numerous studies indicate that parents commonly use paternalistic lies to control emotions and influence behaviour of their children. This has been found to occur cross-culturally. [10] Tzeltal-speaking Mayans, a tribe living in a rural community in southern Mexico, frequently lie to their children. [11] They do not consider these lies as morally problematic and encourage their children to adopt the same practice. [11] However, this can create an honesty paradox where parents live in a society where honesty is promoted as a social value. [2]
A study which looked at parental lying in the U.S. and China showed that while lying by parents in both countries was widespread, a larger proportion of parents in China employed and approved of the practice in order to promote behavioral compliance in comparison to parents in the U.S. Researchers ascribed this variation to differences in cultural values. [10]
Other findings revealed that paternalistic lies negatively influence the parent-child relationship through distrust. [2] Furthermore, a negative correlation has been observed between the perceived frequency of lies told and parental involvement, autonomy support, and warmth. [2]
Controversially, paternalistic lies are sometimes also used in physician-patient relationships. Doctors may give patients an overly optimistic prognosis to provide hope, [4] or they occasionally use placebos on patients to prevent them from feeling disappointed if no alternative cure option is available. [12] These practices call into question the ethics behind them. [13] Potential problems that can arise are:
A placebo is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets, inert injections, sham surgery, and other procedures.
Deception is the act of convincing one or many recipients of untrue information. The person creating the deception knows it to be false while the receiver of the message has a tendency to believe it. It is often done for personal gain or advantage. Deception can involve dissimulation, propaganda and sleight of hand as well as distraction, camouflage or concealment. There is also self-deception. It can also be called, with varying subjective implications, beguilement, deceit, bluff, mystification, ruse, or subterfuge.
Bioethics is both a field of study and professional practice, interested in ethical issues related to health, including those emerging from advances in biology, medicine, and technologies. It proposes the discussion about moral discernment in society and it is often related to medical policy and practice, but also to broader questions as environment, well-being and public health. Bioethics is concerned with the ethical questions that arise in the relationships among life sciences, biotechnology, medicine, politics, law, theology and philosophy. It includes the study of values relating to primary care, other branches of medicine, ethical education in science, animal, and environmental ethics, and public health.
Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice. Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal. These four values are not ranked in order of importance or relevance and they all encompass values pertaining to medical ethics. However, a conflict may arise leading to the need for hierarchy in an ethical system, such that some moral elements overrule others with the purpose of applying the best moral judgement to a difficult medical situation. Medical ethics is particularly relevant in decisions regarding involuntary treatment and involuntary commitment.
In a blind or blinded experiment, information which may influence the participants of the experiment is withheld until after the experiment is complete. Good blinding can reduce or eliminate experimental biases that arise from a participants' expectations, observer's effect on the participants, observer bias, confirmation bias, and other sources. A blind can be imposed on any participant of an experiment, including subjects, researchers, technicians, data analysts, and evaluators. In some cases, while blinding would be useful, it is impossible or unethical. For example, it is not possible to blind a patient to their treatment in a physical therapy intervention. A good clinical protocol ensures that blinding is as effective as possible within ethical and practical constraints.
Self-deception is a process of denying or rationalizing away the relevance, significance, or importance of opposing evidence and logical argument. Self-deception involves convincing oneself of a truth so that one does not reveal any self-knowledge of the deception.
According to the model of the five stages of grief, or the Kübler-Ross model, those experiencing sudden grief following an abrupt realization (shock) go through five emotions: denial, anger, bargaining, depression, and acceptance.
Brain fingerprinting (BF) is a lie detection technique which uses brain waves from a electroencephalography (EEG) to determine whether specific information is stored in the subject's cognitive memory. It was invented by Larry Farwell, a Harvard-graduated neuroscientist, and published in 1995. The technique involves presenting words, phrases, or pictures containing salient details about a crime on a computer screen, in a series with other, irrelevant stimuli to identify whether the suspect recognizes the crime-related items. Although brain fingerprinting has been used in investigations, the test results themselves can not be admitted as evidence in a legal trial.
A nocebo effect is said to occur when a patient's negative expectations for a treatment cause the treatment to have a worse effect than it otherwise would have. For example, when a patient anticipates a side effect of a medication, they can experience that effect even if the "medication" is actually an inert substance. The complementary concept, the placebo effect, is said to occur when positive expectations improve an outcome. The nocebo effect is also said to occur in someone who falls ill owing to the erroneous belief that they were exposed to a physical phenomenon they believe is harmful, such as EM radiation.
The doctor–patient relationship is a central part of health care and the practice of medicine. A doctor–patient relationship is formed when a doctor attends to a patient's medical needs and is usually through consent. This relationship is built on trust, respect, communication, and a common understanding of both the doctor and patients' sides. The trust aspect of this relationship goes is mutual: the doctor trusts the patient to reveal any information that may be relevant to the case, and in turn, the patient trusts the doctor to respect their privacy and not disclose this information to outside parties.
Interpersonal deception theory (IDT) is one of a number of theories that attempts to explain how individuals handle actual deception at the conscious or subconscious level while engaged in face-to-face communication. The theory was put forth by David Buller and Judee Burgoon in 1996 to explore this idea that deception is an engaging process between receiver and deceiver. IDT assumes that communication is not static; it is influenced by personal goals and the meaning of the interaction as it unfolds. IDT is no different from other forms of communication since all forms of communication are adaptive in nature. The sender's overt communications are affected by the overt and covert communications of the receiver, and vice versa. IDT explores the interrelation between the sender's communicative meaning and the receiver's thoughts and behavior in deceptive exchanges.
Insight-oriented psychotherapy is a category of psychotherapies that rely on conversation between the therapist and the client. It involves developing the patient's understanding of past and present experiences, how they are related to each other and the effect they have on the patient's interpersonal relationships, emotions and symptoms. Insight-oriented psychotherapy can be an intensive process, wherein the client must spend multiple days per week with the therapist.
Return of results is a concept in research ethics which describes the extent of the duty of a researcher to reveal and explain the results of research to a research participant.
Georgiann Davis is an associate professor of sociology at the University of New Mexico and author of the book Contesting Intersex: The Dubious Diagnosis. Davis formerly held similar positions at University of Nevada, Las Vegas and Southern Illinois University Edwardsville. Born with Androgen Insensitivity Syndrome, she writes widely on intersex issues and the sociology of diagnosis.
The philosophy of medicine is a branch of philosophy that explores issues in theory, research, and practice within the field of health sciences, more specifically in topics of epistemology, metaphysics, and medical ethics, which overlaps with bioethics. Philosophy and medicine, have had a long history of overlapping ideas. It was not until the nineteenth century that the professionalization of the philosophy of medicine came to be. In the late twentieth century, debates among philosophers and physicians ensued of whether the philosophy of medicine should be considered a field of its own from either philosophy or medicine. A consensus has since been reached that it is in fact a distinct discipline with its set of separate problems and questions. In recent years there have been a variety of university courses, journals, books, textbooks and conferences dedicated to the philosophy of medicine.
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Medical paternalism is a set of attitudes and practices in medicine in which a physician determines that a patient's wishes or choices should not be honored. These practices were current through the early to mid 20th century, and were characterised by a paternalistic attitude, surrogate decision-making and a lack of respect for patient autonomy. It is almost exclusively undertaken with the intention of benefiting the patient, although this is not always the case. In the past, paternalism was considered an absolute medical necessity, as there was little to no public understanding of medical procedures and practices. However, in recent years, paternalism has become limited and blind faith in doctors' decisions has come to be frowned upon.
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Truth-default theory (TDT) is a communication theory which predicts and explains the use of veracity and deception detection in humans. It was developed upon the discovery of the veracity effect - whereby the proportion of truths versus lies presented in a judgement study on deception will drive accuracy rates. This theory gets its name from its central idea which is the truth-default state. This idea suggests that people presume others to be honest because they either don't think of deception as a possibility during communicating or because there is insufficient evidence that they are being deceived. Emotions, arousal, strategic self-presentation, and cognitive effort are nonverbal behaviors that one might find in deception detection. Ultimately this theory predicts that speakers and listeners will default to use the truth to achieve their communicative goals. However, if the truth presents a problem, then deception will surface as a viable option for goal attainment.