Friday, March 19, 2010

Learning to act right (5)…. Learning to lie – the borderlands

Learning to act right (5)…. Learning to lie – the borderlands
Torrey Orton
March 19, 2010

For patients / clients of health services a main focus of accountability is on the practitioner. The health system is a vague backdrop, encountered in private health and Medicare rebates, bulk-billing, ER waiting times and GP clinic receptionists. The practitioner often has little or no control over the system for which they are accountable to the clients / patients.

In my consultant therapist life I am often accountable for things I'm not responsible for. Accountable and responsible are different facets of the same events. More importantly, certain situations embroil me in minor unethicalities, along with most of my colleagues in similar roles, but perhaps not those fully employed in mandated public sector service provision.

For instance, I have to express my concern, sorrow, and disappointment with my (our) performance to a client. A typical event is a mistake in our systems which leads to a therapy appointment not being met. My engagement with a client couple about our failure was done by phone, so the exposure of my apology behaviour competence was high (higher still is SMS and email). In the instance in mind, my expressed concern for client lost time, inconvenience and possible intensified symptoms was appropriate and adequate, but not successful in retaining the client couple. One of them was more forgiving than the other, even after additional efforts by other staff to make up for the error.

Practicing unethical behaviour

My particular interest here is that I was practicing my potentially unethical (lying, to a degree, though one of my readers questioned using this term in such circumstances*) behaviour and had no choice about doing so. I am in danger of increasing my capacity for unethical behaviour, whenever I practice (and so improve) my competence at it. Probably that capacity is already fairly well developed or I could not be a successful adult - or have survived growing up with the limited amount of punishment I actually received (which implies, you can see, the things I did that were unethical in that time which I successfully concealed!).

The ability to dissimulate or deceive is an important survival skill and attitude for most of the injured people I see in therapy, too. They learn to conceal their feelings and associated facts. And here come denial and repression steaming around the corner as tools of personal functionality which we also learn and need. And where do we learn this? At home, of course. One of our parents' most important tasks is to teach us self-defence. The modelling is richly available in their own inconsistencies and self-deceptions.

On the other hand, it is difficult to teach ordinary people (call centre staff for instance) to produce these kinds of lies – especially the pro-forma apology– with anything like conviction. They try to make up for the authenticity shortage with repetition, volume, and false friendliness. You can read complaints of their credibility failures regularly in letters pages and blogs. The learners are usually insufficiently motivated for seriously competent deception, while pro-forma expression is easily detectable as such (see T. Woods and company here.)

So, I guess I'm making a case here for ethical unethicality under some circumstances - the ones in which there is danger of slipping over into the simply unethical! And it is implicit that I'm as susceptible to a slip as anyone, maybe more for as yet unexamined reasons of past slippages in my ethical decisionmaking.

* He suggested it was overkill and that lying implied a definite conscious deception. His perception led me to see how these matters overlap easily. Some deception and some withholding of facts are essential to the building and maintenance of a solid self and from that perspective cannot be seen as lying in the consciously deceptive or misleading sense we associate with unethical behaviour. But, the capacity for keeping our own counsel is also the one which allows us to deceive consciously – which, like most competent functions, must be relatively seamless and natural in its performance or the deception fails. That people can get really good at deception and lying is attested by the endless search for reliable lie detectors and the recurrent failure to find one.

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