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Truthfulness of personal information as indicator of social morality?

ObservationsCan the level of accuracy of personal information items be indicative of the moral virtue of the social system in which the information is used?

This question came to me while I was doing some renovation at home while listening to Tapestry CBC One radio show. This week, Mary Hynes met Sam Harris in the wake of the publication of his book The Moral Landscape: How Science Can Determine Human Values. A surprisingly short interview given that this show’s usual practice is to devote its whole hour to a single personality or subject. By listening to Harris, one understands. He certainly offers a convincing argument about the ability of science to shed light on a moral issue, or even to decide between what is right and wrong. However, the fierceness of his attacks against religions quickly annoys, thus weakening his argument.

Still, neuroscience, for example, can objectively observe through scanner and hormonal analysis that, in general, an altruistic action provides wellness to human beings who do it as those who receive it. It also observes as exactly the opposite effect with a selfish action, that it is even worse for a malevolent action. Many developments in biology, ethology and ethnology as well as psychology and sociology do offer increasingly revealing insights on various moral issues. As Harris points out, science offers here the advantage to transcend cultures, religions and moral systems because of the provable and universal nature of its conclusions.

What with the quality of personal information? The short answer is that, on one hand, science is dependent on the quality of its data and that this quality often depends on the willingness or ability of human beings to tell the truth. Still on the other hand, the level of accuracy of the provided information is measurable… scientifically.

The anecdotal answer comes from to two recent observations about the necessity…  to lie.

Intentional production of erroneous information

The first is the number of recent reports on the census where interviewed Chinese citizens dare to openly declare to be prepared to not respond or even lie to certain questions. So much so that after the pre-census survey, the Chinese authorities have decided not to ask, for example, question the importance of the income of respondents.

The second observation was how I reacted to a question posed by fellow researchers about the appropriate use of personal information for purposes of research and evaluation in health:

“Given that we have a publicly funded health care system, would Canadians not have a responsibility to provide their personal information for health-related research?”

The suggestion shocked me. In particular because it forgets that quite a large share of health costs are privately borne, directly or indirectly, by individuals themselves; that all “research” are not of equal scientific and ethical value; and that it is detestable to impose conditions to ill people for getting care. However, the crucial point for this discussion is that this question reminded me that patients and health professionals medical often produce unreliable information precisely because the “system” is not enough “public” and universal still. Consequently, rather than take pretext of this public nature for imposing their access to patients’ personal data, should instead researchers not find that their reliance on personal data could bring them to ask that services be even more universally pooled and accessible?

With further reasoning, could we not ask the following question: a context or system that encourages people to produce the truest possible personal information for the benefit of all would it not morally superior to that which, on the contrary, incites to produce false information to the detriment of all?

Level of falsehood as test of system

The case of the Chinese census is simple to understand. The Chinese do not trust their authoritarian government whose local officials and public servants are often corrupted and despotic. To the point of openly preferring the risks from avoiding to respond or lying than those from providing truthful answers. Too bad for society and the private and public decision makers who are already struggling to manage the speeding current changes.

The case of medical records is equally revealing. It is well known that in the United States a large proportion of medical records deliberately contain misleading information. Patients and health professionals often have interest to somewhat twist reality to ensure meeting the tough criteria for access to services of private and public insurance and health care programs.

In Canada, the situation is not as dramatic. But the fact remains that several doctors have told me that they often omitted to include a diagnosis, chose to write down one diagnosis rather than another or prescribed one treatment rather than another because of the possible consequences from the information that would appear on file. These consequences may be access or not to a treatment, to a paid sick leave, to health insurance coverage abroad, to compensation for loss of income or enjoyment of life, and even to a job (criterion of the position or insurance coverage requirement).

In short, the need to produce inaccurate information for the benefit of patients follows, among other possible reasons, the limitations of various types of insurance coverage and limitation in the pooling of risks, costs and benefits. As long as such practices remain marginal, one would not have to worry for patients as well as for medical practice, research or administration of health care and other services.

However, whether in health care, census undertaking or other areas, if the amount of biased information items become significant could we not see it as a signal of major systemic malfunction, of fundamental error in principle, even of moral failure?

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