![\"\"](\"https:\/\/3.bp.blogspot.com\/-iV8ByAmRAak\/TlkcuURH1KI\/AAAAAAAABkU\/Q4Mf2LBFGRc\/s1600\/doctor.jpg\")
<\/a><\/div>\nIn the aftermath of the successful assassination of Osama bin Laden, reporters uncovered a deeply troubling scheme the CIA used to verify if bin Laden was resident in Abbottabad. \u00a0CIA operatives organized a sham Hepatitis B vaccination drive<\/a> as a way to procure DNA samples from residents; they hoped to find DNA of bin Laden\u2019s wives or children. \u00a0The operation didn\u2019t end up helping the U.S. locate bin Laden, and, even if it had, I would have found the cost much higher than the benefit.<\/p>\n The doctors and agents carrying out this deception were blaspheming the medical profession, no less so than than the doctors at Tuskegee<\/a>. \u00a0First of all, they actively harmed the patients they \u2018treated\u2019 by administering only two doses of a three dose vaccine (leaving people underprotected). \u00a0The act of deception caused harm to a far broader swathe of people.<\/p>\n You have to be able to trust a doctor administering a vaccine or any medication. \u00a0Even a epidemiology wonk like me doesn\u2019t have the capacity to sample and analyze whatever\u2019s in the needle before the doctor sticks it in my arm. \u00a0People who don\u2019t know much about how immunity and illness work have even less ability to second guess the guy in the coat. \u00a0Since we have no ability to test, the only possible reaction to strong doubts is to opt-out. \u00a0Which tends to have predictably terrible consequences<\/a>.<\/p>\n I doubt any disciplinary action is in the cards for the people who planned and carried out this action, and that\u2019s a shame. \u00a0But I\u2019m not sure this kind of situation could be prevented merely by upping the odds of chastisement and\/or the severity of punishment for transgressors. \u00a0The reason I called this a blasphemy against medicine is because it really ought to register at the gut-punch level of a taboo. \u00a0The trouble is, we\u2019re bad at setting those up.In a post titled \u201cPrices or Bindings<\/a>,\u201d Eliezer Yudkowsky wishes there were a secular equivalent of the seal of the confessional:<\/p>\n If a serial killer comes to a confessional, and confesses that he\u2019s killed six people and plans to kill more, should the priest turn him in? I would answer, \u201cNo.\u201d If not for the seal of the confessional, the serial killer would never have come to the priest in the first place. All else being equal, I would prefer the world in which the serial killer talks to the priest, and the priest gets a chance to try and talk the serial killer out of it.I use the example of a priest, rather than a psychiatrist<\/a>, because a psychiatrist might be tempted to break confidentiality \u201cjust this once\u201d, and the serial killer knows that. But a Catholic priest who broke the seal of the confessional \u2013 for any reason \u2013 would face universal condemnation from his own church. No Catholic would be tempted to say, \u201cWell, it\u2019s all right because it was a serial killer.\u201dI approve of this custom and its absoluteness<\/a>, and I wish we had a rationalist equivalent.The trick would be establishing something of equivalent strength to a Catholic priest who believes God doesn\u2019t want him to break the seal, rather than the lesser strength of a psychiatrist who outsources their tape transcriptions to Pakistan. Otherwise serial killers will, quite sensibly, use the Catholic priests instead, and get less rational advice.<\/p><\/blockquote>\n We\u2019ve learned that institutions aren\u2019t perfect, so we value independent verification and oversight a lot more than we used to. \u00a0Building in safeguards is a prudent choice, but people seem to have a hard time finding a middle ground between total faith and rampant distrust (think of the authority-shy vaccine doubters). How could we go about developing trust and strong expectations of institutions, now? \u00a0We could start by having the Surgeon General publicly condemn the Abbottabad deception, but it would take a lot more than that. \u00a0I doubt that harsh penalties would be sufficient, either. \u00a0The goal is really to build up a strong institutional culture with high expectations for honor.<\/p>\n Bonus reading: Alcoholics Anonymous has been conflicted about whether the relationship between addicts and sponsors should fall into a similar category of inviolable compact<\/a>. \u00a0The ambiguity has had deadly results.<\/em><\/p>\n Bonus reading II: Michael Swanwick has a great fantasy novella \u00a0set in a world with magically-constrained Truth-Tellers. \u00a0He later expanded it to the novel The Dragons of Babel<\/a>, but I think it was much less cluttered as the novella. \u00a0Luckily the whole story I like is available in pages 1-53 of the Google Books preview<\/a>.<\/em><\/p>\n In the aftermath of the successful assassination of Osama bin Laden, reporters uncovered a deeply troubling scheme the CIA used to verify if bin Laden was resident in Abbottabad. \u00a0CIA operatives organized a sham Hepatitis B vaccination drive as a way to procure DNA samples from residents; they hoped to find DNA of bin Laden\u2019s […]<\/p>\n","protected":false},"author":127,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[48],"tags":[194],"class_list":["post-35","post","type-post","status-publish","format-standard","hentry","category-morality-in-practice","tag-taking-out-a-contract-on-your-future-self"],"yoast_head":"\n