HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Robert M. Sade Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sade, R. M. Search for Related Content PubMed PubMed Citation Articles by Sade, R. M. Related Collections Coronary disease Professional affairs

Ann Thorac Surg 2001;72:1449-1453
© 2001 The Society of Thoracic Surgeons

---

Ethics in cardiothoracic surgery

Deceiving insurance companies: new expression of an ancient tradition¹

^a Department of Surgery and Institute of Human Values in Health Care, Medical University of South Carolina, Charleston, South Carolina, USA

* Address correspondence to Dr Sade, Division of Cardiothoracic Surgery, Medical University of South Carolina, 96 Jonathan Lucas St, Suite 409, Charleston, SC 29425, USA
e-mail: sader@musc.edu

Perform these duties calmly and adroitly, concealing most things from the patient while you are attending to him ... revealing nothing of the patient’s future or present condition.

Hippocrates of Cos (460–377 BC)

Two divergent threads of thought regarding truth telling have persisted since ancient times. Examples taken from Plato and Aristotle may illustrate this dichotomy, although ideas from elsewhere in their writings suggest that their views were not as opposed as these excerpts suggest. Plato held that lying in general is to be avoided, but with certain exceptions. "The lie in words is in certain cases useful and not hateful, in dealing with enemies—that would be an instance, or again when those who we call our friends in a fit of madness or illusion are going to do some harm, then it is useful and is a sort of medicine or preventive" [1]. In fact, the ideal society Plato describes in the Republic is a fabric woven from lies told to ordinary citizens by philosopher-kings, who alone are capable of understanding truth.

Aristotle, however, is most concerned with the effects of lying on personal character:

[The truthful person] is truthful both in what he says and how he lives simply because that is his state of character. Someone with this character seems to be a decent person. For a lover of the truth, who is truthful even when nothing is at stake will be still keener to tell the truth when something is at stake, since he will avoid falsehood as shameful when something is at stake, having already avoided it in itself when nothing was at stake. And this sort of person is praiseworthy. [2]

According to Aristotle, lying undermines character and, in the long term, makes achievement of the good life more difficult.

Over the . . . [Full Text of this Article]

This article has been cited by other articles:

				J. P. Everett, C. A. Walters, D. L. Stottlemyer, C. A. Knight, A. A. Oppenberg, and R. D. Orr To lie or not to lie: resident physician attitudes about the use of deception in clinical practice J. Med. Ethics, June 1, 2011; 37(6): 333 - 338. [Abstract] [Full Text] [PDF]

				A. L. Estrera, S. Ikonomidis, J. S. Ikonomidis, and R. M. Sade Impending Loss of Insurance Coverage is an Indication to Proceed With Complex, Expensive Surgery Ann. Thorac. Surg., June 1, 2010; 89(6): 1709 - 1716. [Full Text] [PDF]

				J. P. Jacobs, R. J. Cerfolio, and R. M. Sade The Ethics of Transparency: Publication of Cardiothoracic Surgical Outcomes in the Lay Press Ann. Thorac. Surg., March 1, 2009; 87(3): 679 - 686. [Full Text] [PDF]

				R. M. Sade Profits and professionalism J. Thorac. Cardiovasc. Surg., March 1, 2002; 123(3): 403 - 405. [Full Text] [PDF]