…And a lesson in human communication.

Christopher Nolan’s Interstellar is a movie filled with beauty and awe. It has received somewhat of a beating from hard core science fiction fans; but from a philosophical point of view, it is filled with little gems such as this one.
A bit of background: In Interstellar, the role of space marines is taken by some weird-looking rectangular robots (an homage, perhaps, to 2001‘s monolith?) The one named TARS makes an appearance in this scene.

As their shuttle leaves Earth, on its way to a very long trip, Captain Cooper (Matthew McConaughey ) muses on the difficulties of leaving behind their loved ones. He receives a tart response from a member of the crew…

Interstellar (2014). Directed by Christopher Nolan
Posted in YouTube by YaBoySuper

(The volume in this clip is a bit low; you’ll need to turn it up, but I suggest you test before using the clip.)

Themes: Honesty, truthtelling in health care. Kantian ethics vs. Utilitarianism.

Teaching tips:

The clip can be used for a general ethics discussion on the practical limits of honesty, and the shapes it takes in regular conversation. Can we be 100% honest? Is this “neither the most diplomatic, nor the safest form of communication with emotional beings”? Does socially acceptable communication require a certain dose of dishonesty?

In the realm of applied ethics, the clip is a great prelude to a discussion about a very practical set of issues: truthtelling in health care ethics. Should a doctor be completely honest with all of his or her patients? If so, is the obligation to be honest stronger in health care than in normal communication? Or is it a better standard of practice to “manage” the content of one’s communications with patients?

Questions for discussion:

General Ethics:

  • How does TARS (the robot)’s assertion fit with, say, Kant’s use of truthtelling as an example of the Categorical Imperative? Or in plainer words: Is it immoral not to be 100% honest?
  • (Of course, one may ask, what does “90% honesty” mean in any case? Can such values be quantified?)
  • Does social communication require a certain degree of dishonesty? On what grounds? And if so: how much dishonesty is morally acceptable?
  • You can also use this particular issue to present a conflict between kantian and utilitarian views.

Health Care / Biomedical Ethics

  • What are the reasons for the professional obligation (or, if you prefer, the current professional standard) of truthtelling? In other words, how would you justify that there is a strong obligation on the part of medical practitioners to tell the truth to the patients?
  • How far does this obligation go? Does it require that the doctor tell “the whole truth” in all cases?
  • Some authors (see below) have argued that, for the benefit of the patient, the doctor should have the option not to reveal their diagnostic, or to mislead the patient through silences and technical jargon. This, in order to spare the patient the shock and horror of the bad news, the “death sentence,” and allow them some peaceful last days. (This is how it is argued.) Is this practice acceptable? Is this well-meant but ill-conceived paternalism? Is this ethical?
  • Would telling “the whole truth” be more recommendable?
  • What could be an alternative approach in such a case, one that protects the patient while respecting the obligation to tell the truth (and the patient’s autonomy)?
  • You may bring the discussion further, and ask: If some degree of deception were acceptable, what about the use of placebos in medicine?

Also see:

There are a number of authors (both from the philosophical and the health care fields) that have argued back and forth on the issue of truthtelling, and whether a certain degree is acceptable in the health care professions. Here are some classic examples:

  • Shelly K. Schwartz: “Is it Ever OK to Lie to Patients?” Physicians Practice (2010). (Quite thorough, strongly for disclosure and full truthtelling.)
  • Mack Lipkin: “On Telling Patients the Truth.” Newsweek (June 4, 1979). (The critical issue is whether the deception is meant to benefit the patient or the physician.)
  • David Thomasma: “Telling the Truth to Patients: A Clinical Ethics Exploration.” Cambridge Quarterly of Healthcare Ethics, 1994. (Truthtelling can be trumped by more important values.)
  • Susan Cullen & Margaret Klein: “Respect for Patients, Physicians, and the Truth.” In R. Munson’s Intervention and Reflection, 8th ed. (2008). (Rather than a blanket judgment, considers in some depth various complex situations.)
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