This one is easy. A son, racked with guilt because he missed his dying father’s last moments in a hospice because he was drunk, asked his father’s physician if Dad had suffered. The doctor answered that he had died in his sleep, peacefully. In reality, though the doctor wasn’t present, there was some indication that the father had been “in distress” before he shuffled off these mortal coils, according to some in the shift on duty.

“Did I betray a position of trust by lying to him?,” the doctor asks The Ethicist, aka. Kwame Anthony Appiah. “What, if anything, makes a lie morally acceptable?”

No, the doctor didn’t betray a position of trust because the dead father was the patient, not his son. The MD had no professional duty to the son in this situation, any more than it would have been unethical for him to bluff the son into folding a winning hand in a poker game. What makes a lie morally acceptable, that is, ethical, is when it accomplishes more good than the truth would, particularly when the truth would achieve no good at all except in an ethical system where the truth is always the best course. Which is to say, Fantasy Land.

Let’s consider the various options open to the doctor.