Discussion - Real Photography

With the advent of digital photography, it is easier than ever to combine or alter images with a simple click of the mouse. It does begin to bring up the question; can we really believe what we see?

Considering that photography is a medium that can convey a million emotions in one single image, is it ethical for a photographer to draw more emotional response by digitally altering an image? Is this any different than using different lighting in a studio to create an effect?