Non-judgmental Ethics Sunday: Should a Nephew Be Told Who His Real Father Is?

April 10, 2016 by Joshua
in Ethicist, Nonjudgment

Continuing my series of alternative responses to the New York Times column, The Ethicist, looking at the consequences of one’s actions instead of imposing values on others, here is my take on today’s post, “Should a Nephew Be Told Who His Real Father Is?

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My sister has told me that her son is not the biological son of her husband. His sperm count was very low; she was having an affair and became pregnant. The son looks not like his father but like the other man. Her son (he is now middle-aged) doesn’t know, and her husband (they’re now divorced) doesn’t, either. Recently, when my sister had a health crisis, she told the other man for the first time, asking him not to tell anyone. He told her that was his decision. He has no other children. Now he knows he has a son and a grandchild.

Here’s my dilemma. I promised I would tell no one, and I have kept my promise. But I am haunted by the knowledge that her son does not know who his real father is. I am a father with a son and would want, under any circumstances, to know who my father was. What is your counsel? Name Withheld

My response: Normally I write about how the issue isn’t if you should act but how you should act. If you don’t have the skills to say anything without ruining your relationships, keeping your promise or not doesn’t matter. If you have the skills to make everyone comfortable with what you say, it also doesn’t matter. You can always talk to your sister independent of the promise issue. If you have the skills, why don’t you start there? If you don’t have the skills and expect you’ll ruin relationships all around, you might as well keep things to yourself until you develop them.

I stand by that perspective, but I can’t help but focus on the stupidity of promising things before knowing what they are. I rarely use the word stupid, but I think it applies to saying yes to the question, “If I tell you something, will you promise not to tell anyone,” at least if you’re over twelve. I’ve written about this before. If you agreed to something blindly, you made your bed. The issue is your credibility, which you would likely sacrifice in some people’s eyes from saying you would do one thing and then doing another. Unless you weren’t yet an adult when you promised, but as an adult you probably want to maintain your credibility. If you were as immature in age as the promise you made, then you can probably get off for your youth, but that doesn’t sound to be the case.

Anyway, I recommend learning from the experience.

If you agreed after she told you, well, then you’d have a lot to figure out below the level of this question, but I don’t think that’s the case.

The New York Times response:

You’re right to give serious weight to the thought that if you were in your nephew’s situation, you would want to know. It’s a compelling consideration. We all have a — perhaps irrational — concern to know our biological parentage. In the age of genomics, we may even have a medical rationale for wanting to know. And for a variety of reasons, it’s morally important to learn the truth about matters you care about.

But do such considerations trump your obligation to keep your sister’s confidence? If you tell, after all, it’s your sister who will have to explain to her son why she has kept this fact from him and face his likely reproaches (spoken or not) for her infidelity to the man your nephew always thought of as his father. There’s also a serious chance her ex-husband will find out, which could lead to more distress, not least because it may disrupt his relationship with the man he raised as his son. And consequences aside, there’s the simple, forceful fact that you gave your word.

The best outcome, I suspect, is one in which you persuade your sister to tell her son herself. Aim for that. She surely knows her son better than you do and will have views about how the revelation would affect him; she’ll also have views about how to manage their relationship afterward. And if she still refuses to tell your nephew? Listen to her side of things before you decide whether it’s your place to be the bearer of this news.

I am an avid art collector of mostly regional or less-publicized artists. I try to buy directly from artists, as they then receive 100 percent of the price as opposed to 80 percent, or even 50 percent, if I buy through a gallery. Recently I found a piece online by an artist I love. It is one of his finest works. I was able to buy it for far, far less than what the artist’s work sells for these days. My mind tells me there is nothing wrong with this, but I’ve been feeling uneasy ever since. I also happen to know the artist, but we are not personal friends. What do you think? Name Withheld

My response: Did you leave something out of the story? Consenting adults legally exchanging a product for legal tender.

I think your issue is more about your own self-awareness and how to understand and handle your emotions since what seems to have prompted your letter is your unease. Or maybe to learn that you’re letting your sense of judgment apply to areas where it’s irrelevant.

The New York Times response:

Assuming that the seller wasn’t the artist or his gallery, surely none of the proceeds were going to the artist. Paying more wouldn’t have helped him. The only way you might have hurt him is if the sale was recorded, because the prices of an artist’s work can be affected by sales averages. But one online sale isn’t likely to matter.

So the sole party who might have a moral claim against you is the seller — and the seller picked the price, not you. The lesson of all those stories about Rembrandts found at garage sales is that buyers have no obligation to inform sellers that they could charge more. The obligations run in the other direction. Sellers are supposed to inform buyers if a good has a known defect that affects its value, unless they are explicitly selling “as is.” No inverse convention requires buyers to inform sellers of unknown advantages.

There’s a good reason for this. The person possessing the object is better positioned than the buyer to explore its properties before offering it for sale (economists call this “information asymmetry”), and it’s in his or her interest to do so. In the age of Google, what’s more, there are lots of price databases online. So you can stop worrying about your purchase’s ethics and just enjoy its aesthetics.

The school district where I live just settled a teachers’ contract retroactively. Teachers lost significant benefits and are disheartened as they brace themselves for negotiations for the coming year. Instead of spending hours finessing college letters of recommendation, I have suggested that we teachers use a form letter noting that Johnny passed the class and is eligible to apply to the college in question. Period. Most teachers find cursory treatment of letters distasteful, but this is one way for teachers to make clear how much time they devote to their jobs outside the workday. Is it unethical to pursue this tactic when facing contract negotiations that do not account for the unpaid hours teachers devote to their profession? Students are not denied letters, but they would not be letters painstakingly crafted by professionals. Name Withheld

My response: As usual, the New York Times picked a story asking abstract philosophical questions and absolutes about simple interactions.

As usual when someone asks about ethics, I suggest looking more at the consequences of your actions and using compassion and empathy to evaluate the results, not abstract philosophical reasoning. It seems to me no matter how right you and your colleagues consider yourself, everyone will see you as selfish and holding decades of these kids’ futures ransom.

I predict people will see you like Walter in the Big Lebowski. As The Dude said to him:

“You’re not wrong, Walter, you’re just an asshole.”

If you want to risk people thinking of you that way, enjoy being right and everyone hating you.

The New York Times response:

It’s an awful thing when school districts undermine the professional confidence and self-respect of teachers. Public education is a major responsibility of our communities; we need dedicated teachers and working conditions that sustain them. Still, if writing carefully composed college admissions letters is part of the job, not doing so is an undeclared work stoppage that penalizes students, who are not to blame for the failures of the school board. Many teachers, precisely because they are dedicated professionals, would have a hard time bringing themselves to do it. They know that kids who lose scholarships or admittances as a consequence may have no chance of a do-over. But that’s the trouble with the poor state of relations between management and employees in schools: The main victims are our children.

I am a vascular surgeon. One of the diseases I treat is aortic aneurysms. Recently, a patient presented in extremis to the emergency room with a rupture of his aneurysm. He told me that he had known about the aneurysm and had declined elective repair in the past. I was frank about the risks of surgery and the likelihood of a poor outcome. I was also truthful when I told him that without surgery he would definitely die soon but comfortably, and that the only, albeit slim, chance of surviving this event would be going immediately to the operating room. His family was hours from our hospital. He decided to proceed with surgery and indeed died from complications.

My question: Is it ethical to refuse to operate on a patient like this, knowing that he had declined surgery in the past? It would save a lot of resources and heartache (at least for me, the surgeon). I believe that in the heat of the moment (i.e., facing death), patients panic and want “everything done.” Name Withheld

My response: Did you leave something out of the story? Consenting adults legally exchanging a service for legal tender.

I think your issue is more about your own self-awareness and how to understand and handle your emotions since what seems to have prompted your letter is your unease. Or maybe to learn that you’re letting your sense of judgment apply to areas where it’s irrelevant.

I don’t think you’re claiming that people facing death aren’t sane enough to decide. If you are, good luck getting far with that gray zone. We’re all facing death.

The New York Times response:

Certainly not. Even if his earlier doctor’s clear recommendation was for surgery, declining elective repair was still the patient’s choice to make. So was pursuing the emergency, low-odds surgery with you. Medical treatment is not the prerogative of people who make good choices.

You suggest three reasons for refusing him surgery. First, because he made the wrong decision earlier. Second: It was a waste of resources. Third: His death was painful for you. The first and third reasons sit badly with me. It’s not your job to judge the earlier decisions of your patients — you don’t withhold surgery from an accident victim who neglected to wear a seatbelt — and as a surgeon, you’re obliged to do the best you can for your patients, even if it discomforts you.

I have some sympathy, though, with the second reason. The costs of treating people are borne by all of us, through taxes and insurance premiums. We cannot spend all our resources on medicine. So we have to make decisions about what we will and won’t do. Difficult and expensive surgery with a very low probability of prolonging life is the sort of thing that we can reasonably decide we won’t do. That tenet wouldn’t normally apply to surgery for ruptured aortic aneurysms, which I gather has a mortality rate of about 50 percent. (Not good, but not terrible.) Yet there may be procedures for which the ratio between resources and results is wildly lopsided.

Decisions like these, however, aren’t to be made on the fly by a single physician. We need to get clearer, institutionally, about what our criteria are for rationing long-odds surgery. And we need mechanisms for working out which interventions should and shouldn’t make the cut.

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