13.2 - Sincerity

In this episode, John and Michael lay out the nature of the virtue of sincerity and why it is important for physicians to be sincere, both to their patients and to themselves.

20 minutes • Published May 25, 2026 • Download • Transcript

Chapters

Transcript

[Intro music]

Welcome to the Hippocratic Society Podcast. This podcast is a project of the Hippocratic Society.

In the podcast, we aim to reflect on deeper questions in medicine, all with the aim of rediscovering the ideals that brought us to medicine in the first place in order to better serve our patients and colleagues.

Thank you for joining us and we look forward to engaging with you through this podcast.

Hi and welcome back to the Hippocratic Society Podcast this episode. We are following up from our episode with Dr. Fabrice Jotterand where we talked about moral bioenhancement.

In that episode we talked a lot about why we need the virtues, how to deal with AI.

And so talking with John, we thought a good follow up virtue would be sincerity. And John, I was wondering if you could first tell us why you thought sincerity was a good follow up to moral bioenhancement and how they're related.

Yeah, sure, Michael. The reason why I was thinking that it could be a good virtue related is even in the past year there's been a huge increase in the use of AI.

And for most people,

their daily use of AI is with large language models.

And there's also been a lot of news articles and various kind of. Yeah, even discussions among friends as to how large language models are being used,

whether for good or for bad.

And I think the interesting thing about the LLMs is that so much of the what's being done on one's computer might not be known to anybody else. Like you might be using an LLM to write a college essay, let's say,

and unless you reveal that your professor might not know, other people might not know, unless they're very savvy or you're not very savvy and you're not very good at perhaps like modifying the essay or whatnot.

And I think that because of the fact that these things are done in some sense in private,

that without the virtue of sincerity, I think that there's potentially a lot of harm then that can be done in terms of how we use LLMs.

Yeah, yeah, that makes a lot of sense and very relevant topic. Seems like every conversation I have is talking about AI.

No, but this is, this is different. I'm very excited for this, John.

So yeah, why don't we start out, I guess by the usual way we start out, which is like, what is sincerity? What are we actually talking about here in terms of the virtue?

Yeah, so sincerity comes from the Latin word sincerus.

And what it refers to is this idea of unmixed or pure or like has one foundation of growth or coming from a single source. And so Aquinas would actually say the virtue of sincerity therefore has a sense of both integrity, which is a virtue that we've talked about in the past.

So not being duplicitous, like not having many different kind of ways in which one presents oneself,

but also the foundational basis of truthfulness.

And so it brings these two virtues together,

both the truthfulness and the sense of integrity.

And so this idea of like unmixed or coming from a pure source or one source, or is this idea that when you are sincere, you are genuine, you are your authentic self, that there's not a sense of being two faced, or there's not a sense in which you are acting in one way in one situation,

then in another way in another situation.

Especially as it has to do with morals. Right. We're not, we're not talking here in the, in the sense that like it's also natural, sometimes we act a little bit differently in different social situations because circumstances or professional circumstances or whatever.

Naturally we, we act a little bit differently in different places as the circumstances also dictate certain types of cultural norms that we should be following.

But what this is more talking about is, is, is, is this idea of this, the moral self, right? Is that, is that consistent across all these different places? And you know, we've talked about before that perhaps prudence is arguably the most important virtue because of this idea that it brings together the,

it's the charioteer of the virtues,

the overlap of the intellectual and the moral virtues.

Or others may argue that charity is the highest virtue because all of the virtues really depend on this bond of love.

And Aristotle would say sincerity may be the kind of foundational virtue, or Aquinas might say that it's a foundational virtues on which many of the other virtues can build on.

Because only if you are truly sincere in the sense that you're truthful to yourself as well as to others, you are genuine, authentic,

always as to who you are,

that then all the other virtues can foundationally grow on that particular virtue.

Yeah, that makes a lot of sense. So maybe like sincerity would be the foundation necessary to grow the virtues. Prudence could be sort of how to apply the virtues in different situations.

And then charity is maybe the ultimate virtue. Some might say what all the other virtues are aiming towards being.

There's sort of this upward trajectory, I guess, of sincerity, prudence, charity, maybe.

But yeah, that makes a lot of sense in terms of being true to yourself, both for yourself and for others.

And so, yeah,

I'd love to dive into a little bit more of applications. Why is this so important for medicine? Clearly, it's important for virtues and the moral life.

But in medicine specifically, what. What makes sincerity really salient?

So I would say perhaps on the side of physicians,

I think this idea of sincerity is especially important today,

and especially during this time of training where all of these new technologies are coming out in medicine,

whether we are being honest and leaning into the virtue of fortitude to.

Despite the fact that it's more difficult doing things in a process in which we are truly growing rather than finding shortcuts to things. Right.

And I think the place where sincerity comes into play in that is that there are these in between things. Right. And so what is truly about my learning and true growth in terms of how to be a doctor versus what are things that maybe are allowed to use tools to be more efficient?

Right.

And so there are certain circumstances where the tools that we do have actually are helpful in terms of making things more efficient and actually maybe with the ultimate goal of helping patients.

Right.

But sometimes,

or I would say, and many times there is this in between space,

and that's where the virtue of sincerity is so important,

because we could easily convince ourselves that, like, oh, I'm doing this ultimately for the patient's sake,

but really it's not a bad thing, even though I kind of know it's probably not the best for my formation or development or whatever it might be. Right.

And I think it's in those places that we have to be careful, because as we talked about with all the virtues, if we act against the virtue, so if we act towards the good,

then over time it makes it easier and easier to practice the good and be the good itself.

But conversely, if we act against the good,

then over time, it becomes easier and easier to act towards the vice.

And so if we're repeatedly being insincere with ourselves in how we use these tools, then it becomes easier and easier to sometimes lie to ourselves up to a point where we might not actually even be able to recognize the good because we've practice the lie so many times that we have in some sense become the lie.

Right.

I think this is especially the case where there is a clearer moral good that should be done in the process of education.

Right. So education is not just about getting a task done,

like an essay done, for example, but rather education is about being formed,

being molded. And so the process of doing that particular task is just as important as the outcome of the essay. And I would say in medicine, that's especially the case if we were going to be good physicians to a degree.

We have to know the process of how to reach a certain diagnosis or how to even write a note if we are to then be able to recognize the scenarios where things are a little bit different or things are a little bit anomalous.

And therefore we are able to then understand it still through this clinical lens of how we've learned and been educated over time.

Right.

So I think that there's this aspect of being sincere as a physician in terms of the education process.

I think there's also an aspect of sincerity that's important in the clinical setting because so much of medicine over time I've learned more and more that has to do with, like, our relationships with others.

And some would say that the virtues are. Can be all categorized into the four cardinal virtues. And the cardinal virtues are cardinal virtues because they're the hinge virtues. And in some sense they actually, all the other virtues are kind of contained within them.

And sincerity traditionally actually is part of the virtue of justice.

And I think it's because of the fact that it is related to what is in some sense even due to others, by being authentic or genuine. Right. That we in some sense owe it to others to try to show them who we truly are,

our true selves, and not just some hidden version of ourselves.

And so, especially with work with colleagues,

sincerity builds trust. And sincerity is also the foundation for not just truthfulness, but also trust building.

And in an environment where we're caring for patients,

trust building and truthfulness can only build on the sense of sincerity. And so being sincere, being our genuine, authentic selves with our colleagues is also crucial for the care of the patient and then for the patient, especially as a palliative care physician, I see this a lot, that there's this wrestling within oneself of what it means to be sincere in the clinical visit.

Right?

Because there is a sense of sincerity of like, how much to share with the clinician,

perhaps because of other fears of will the clinician not give me my treatment because I'm weaker than I am and whether I show that or not or whatever. Right. But then also an interior sense of sincerity of like, coming to terms or confronting the difficult things that illness contains.

Right. Whether that's like ideas of recognizing and also seeing that prognosis may be limited,

but also still hoping,

but one has to still come to terms honestly with the realistic aspect of the prognosis too. If one is able to then build on that in order to then live each day as fully as one can.

Right.

And so there is also an honest kind of confrontation with both what may be happening in order to then be able to build on many of the other virtues, I think as a person going through an illness as well.

Well, yeah, okay. A lot there. So there's touched on three categories. The educational side of being sincere about sort of what we need to grow, what we are doing in our education,

taking that seriously,

and then with colleagues, sort of as a physician being showing our true selves and then in suffering, which in some sense I think maybe encapsulates the other two because they're just a lot minor form, a lot lesser forms of suffering.

And in showing our true selves might be uncomfortable or the discomfort of going through an educational process and doing things in a way that's a little bit longer than taking a shortcut,

but to a deeper extent in that third area in the patient experience of sincerely facing a challenge and a deep challenge of suffering.

Yes. I mean, there's. There's a lot there. I wonder if we could touch maybe on. On some more practical aspects of. And maybe some examples of how to live sincerity, especially when it's difficult situations that come to mind are when we're facing sort of our own shortcomings or the shortcomings of others.

Having to face up to saying I don't know to an attending who's asking you questions in training,

or you see a colleague do something that is harmful to patients and having to confront them about it or go through the channels of correction.

Yeah.

I wonder if you could talk a little bit about that and how to approach sincerity when it's particularly difficult.

Yeah. I think that like a lot of these really great virtues, the way that we sometimes grow in those, like, larger virtues or foundational virtues oftentimes,

and we've mentioned this in other podcasts as well,

is to look at the adjacent virtues, because those can then sometimes help pull up that those virtues that maybe can be harder to cultivate or grow in due to other maybe anxieties, weaknesses that we all have.

Right.

And so I think the virtue with sincerity that maybe is the most clearly,

like, directable in terms of our attention and trying to see how we could grow in it would be truthfulness. Right.

And sometimes truthfulness is much easier to measure because,

you know, it's. It's. Whether we're being truthful in a particular situation or not is clear. Although of course, there are complex situations where there's intentions in play and how truthful one should or could be, or anyway.

But generally speaking,

one is truthful.

Saying the truth or lying. Right. And aiming towards being truthful in all situations, I think then helps one to grow in sincerity.

Another thing that I would say is something that we've been thinking about and speaking about also in other contexts of virtue is how we take a moment to pause to try to identify what the good is in all of the different circumstances that we find ourselves in.

And so the other day I was talking with a patient and they were sharing with me this idea that I spent like an hour with them even for a 30 minute visit.

And very empathetic with them, I know, especially with this patient I am. And the other day they shared with me that they felt disappointed because I was not doing enough.

And of course say that's possible.

But I know in this particular circumstance I give this patient even more than like other patients,

perhaps even to a degree that maybe I shouldn't.

And they said, well, we just want to be honest with you.

And I don't know if that's true sincerity,

because there is a difference, I think, between knowing that, which is also just a weakness from our own sense of anxiety or comfort seeking or whatever our predominant kind of weakness is.

And in that case, if one takes that mindful approach and takes a pause and recognizes actually it doesn't have to do with how this doctor is treating me. But actually there's something else here that is making me feel this way or think this way.

Right.

And if that's the case, then I don't have to tell this doctor something that's like, actually in some sense untrue in an objective sense. Right.

That's not to say I still tell the patient, like, yeah, share with me whatever's on your heart because maybe then we could work through it together.

But I just want to make that distinction because sometimes we think like,

oh, just saying everything that is apparent, it means that we're growing in sincerity. No, like, we still have to think about, like, what is the good involved here?

What does it mean for me to like grow in a genuine, authentic sense of myself here? And sometimes these like, anxieties or weaknesses are actually getting in the way of us being our genuine, authentic self.

And what does it mean to actually be that wholeness, that pureness that is the root of sincerity. And so again, taking that pause, I think is important.

I think that that's especially important in these cases that we were talking about of like, how tools might be used. Because in our work, because if we're using a large language model, for example, because we want to make sure that we have the most up to date information before we see a patient on the most recent randomized trial on this particular drug.

So that I understand clearly what the time to next progression was on average, et cetera, like all the summary information to be able to really tell the patient what that data shows.

That's a good use of large language models. Right.

So that I could be truly there informing the patient. Right.

But if I'm using a large language model, because it's much easier to write this review paper and for the large language model to just summarize things that is in the literature for the review paper and then saying that it's mine,

clearly that's not a good use of large language models or not an honest use of it. And so those are maybe more clear examples. But I do think that those are examples that probably people are struggling with as to what is true growth and authentic self of what it means to be both truthful and my full self,

and what takes me away from that and in all these circumstances to take a pause and be able to reflect and see is this drawing me towards the good in a real way or not,

I think is also an important consideration.

Then lastly, I think the virtue of the sense of integrity, which you know, won't go into because there was a whole other podcast on integrity and you could go listen to that if you want to think about how to grow in integrity.

But, but I also, part of that is to always try to be my genuine self in all circumstances and what that looks like in different circumstances.

Again, recognizing that there might be cultural norms, et cetera, but that there is a difference between things that are meeting cultural norms in particular circumstances and what it means to present who I truly am as myself in all of those circumstances.

So three sort of points there, one being truthfulness, and so what is required from truthfulness, I think the second maybe we could say is the pause, which seems to be across all virtues,

maybe the fundamental act of growing in the moral life. And maybe that is really the core of sincerity, that sort of pause and being truly in the present.

And then finally the integrity of living that out across time and across situations and different circumstances.

Wonderful. Yeah. I think this gives a really great picture of sincerity in medicine. And I think that's a great place to end it. Yeah. Thank you, John.

Yeah, thank you, Michael.

We'll see you next time on the Hippocratic Society podcast.

Thank you very much for joining and reflecting with us today.

Keep up with new episodes by subscribing to the Hippocratic Society Podcast.

For more information on the Hippocratic Society,

Visit us at hipsoc.org. The Hippocratic Society is a 501(c)(3) and depends on the generous support of its listeners.

And as always, we'll see you next time on the Hippocratic Society Podcast.

Loading...

0:00 / 0:00

Loading...

0:00 / 0:00