Should we journalists use the word “lie” to describe President Trump’s most manifest falsehoods?

That debate has roiled the news world. The Times this week used the word “lie” in a front-page headline, and I agreed with that decision, but there’s a counterargument that lying requires an intention to deceive — and that Trump may actually believe his absurd falsehoods.

So in 2017 we reach a mortifying moment for a great democracy: We must decide whether our 45th president is a liar or a crackpot.

Yet the costliest presidential falsehoods and delusions are not the ones that people are talking about, such as those concerning the inauguration crowd or electoral fraud. The most horrific chicanery involves Trump’s new actions on women’s health that will cause deaths around the globe.

It followed the weekend’s stunning women’s marches: At least 3.2 million people apparently participated in all 50 states, amounting to 1 percent of the U.S. population. In a slap at all who marched, Trump this week signed an order that will cut off access to contraception to vast numbers of women, particularly in Africa.