Outline of Armstrong Essay

ISSUE: How do we justify the secrecy and protection of harmful information in professional life? We often place ourselves in conflict with the duty of advancing the public interest, and the duty to do no harm.

Secrecy = blocking access to information.
Confidentiality = not sharing information given by a particular person.

Problem: Keeping information secret (no public access) or confidential (not sharing what a particular person has said) often produces harm.

Two methods of justification: DEONTOLOGICAL and UTILITARIAN.
This essay focus on the deontological approach, by outlining PRIMA FACIE duties.

PRIMA FACIE DUTIES are our basic prescriptive norms (i.e., morally binding rules). However, "prima facie" means "at first look." A second look will often reveal conflicts among our duties, in which case we must examine the particular case to determine which duty must be waived or relaxed.

Two basic kinds of duties: Positive and negative.

Positive duty = a duty to do something. For example, the duty of charity requires you to give help to others.

Negative duty = a duty NOT to do something. For example, the right to life is equivalent to a negative duty not to kill.

Positive duties are basically ideals. You should do them, but it is largely up to each individual to decide when and how to do them. We don't normally punish someone for failing to do them.

Negative duties are strict rules and we normally punish anyone who violates them.

When a positive duty to help society conflicts with a negative duty (don't violate confidentiality), the balance normally shifts to the following the negative duty and setting aside the positive duty. BUT NOT ALWAYS!

FOUR RULES WHICH TOGETHER LET US PURSUE POSITIVE DUTY:

1. The good we pursue must be an objective, realistic prospect.
2. The infringement cannot be avoided in bringing about the good end.
3. We have the least infringement possible in the circumstances.
4. The agent minimizes harmful effects of the infringement.

[MY COMMENT: This list leaves out a fourth condition that is normally put on such cases: we can't do the wrong thing (the infringement) as our means to doing the good thing -- it can only be an effect of doing something else.]

THREE EXAMPLES

Medical Professionals

The AMA prioritizes confidentiality above avoidance of harm. Doctors should violate patient confidentiality ONLY if required by law. Example: If a psychotherapist/psychiatrist believes that a patient may harm someone, the therapist should not breach confidentiality. In response, many states now require therapists to warn potential victims of foreseeable harm.

Engineering

Safety and well-being of the public takes priority. Conflict: employers do not want employees to expose their mistakes. Solution: limited "whistleblower" protection protecting employees who inform on suspected illegal acts.

Accounting

Code for CPAs dictates a positive duty to protect the public. However, they also have a negative duty of confidentiality. In practice, the public is protected only if the client explicitly consents or there is a legal obligation. Informing the public is effectively blocked.