I think something that a lot of discussions here forget is that human modeling of humans (including themselves) is a leaky abstraction. However much we think we’re perfect consequentialists, and able to know when violating a rule is best overall, and able to know all the impacts enough to mitigate the downsides, we’re often wrong.
It doesn’t matter if the doctor gets caught specifically. It’s going to get out that sometimes doctors violate confidentiality. No matter how hard they try to keep it quiet, it had an impact (duh! that’s WHY they did it) and it will be low-key known. In fact, it is known, and nobody would be surprised at all by any of your examples.
Also, a doctor who violates confidentiality once has suffered a permanent loss in their own ability to uphold confidentiality in the future. And taken on a whole lot of stress and pain in keeping secrets, which they’re likely to confess to THEIR doctors or perhaps close friends.
Contributing to the dilemma is the wide variance in human capabilities and motivations. Most groups contain a significant population of idiots and, if not full psychopaths, at least self-centered jerks. And there’s a weird idea that laws should apply equally to everyone.
My solution—recognize that the rules and heuristics which allow cooperation in our societies are imperfect, but enforce them anyway. Godel’s Theorem applies to law (in which I include social behavioral strictures), and it CANNOT be complete and corrrect. Someone enlightened enough to break the law for good reason must either pay the costs of hiding it, or suffer the consequences of being caught in the violation. Don’t try to make more epicycles and exceptions until the rules are so obtuse that they’re not actually useful as rules for most people. Instead, take the hit that sometimes someone will be punished for a good act.
Note—this makes some acts even more heroic (remember, heroism is suffering for a sympathetic cause). If https://en.wikipedia.org/wiki/Stanislav_Petrov had been executed rather than just shuffled around for his crime of saving humanity, he’d be a martyr rather than “just” a rationalist example of good consequentialism.
I think something that a lot of discussions here forget is that human modeling of humans (including themselves) is a leaky abstraction. However much we think we’re perfect consequentialists, and able to know when violating a rule is best overall, and able to know all the impacts enough to mitigate the downsides, we’re often wrong.
It doesn’t matter if the doctor gets caught specifically. It’s going to get out that sometimes doctors violate confidentiality. No matter how hard they try to keep it quiet, it had an impact (duh! that’s WHY they did it) and it will be low-key known. In fact, it is known, and nobody would be surprised at all by any of your examples.
Also, a doctor who violates confidentiality once has suffered a permanent loss in their own ability to uphold confidentiality in the future. And taken on a whole lot of stress and pain in keeping secrets, which they’re likely to confess to THEIR doctors or perhaps close friends.
Contributing to the dilemma is the wide variance in human capabilities and motivations. Most groups contain a significant population of idiots and, if not full psychopaths, at least self-centered jerks. And there’s a weird idea that laws should apply equally to everyone.
My solution—recognize that the rules and heuristics which allow cooperation in our societies are imperfect, but enforce them anyway. Godel’s Theorem applies to law (in which I include social behavioral strictures), and it CANNOT be complete and corrrect. Someone enlightened enough to break the law for good reason must either pay the costs of hiding it, or suffer the consequences of being caught in the violation. Don’t try to make more epicycles and exceptions until the rules are so obtuse that they’re not actually useful as rules for most people. Instead, take the hit that sometimes someone will be punished for a good act.
Note—this makes some acts even more heroic (remember, heroism is suffering for a sympathetic cause). If https://en.wikipedia.org/wiki/Stanislav_Petrov had been executed rather than just shuffled around for his crime of saving humanity, he’d be a martyr rather than “just” a rationalist example of good consequentialism.