First, my gut feeling is (w/o knowing anything about the domain really): You may well be exactly right to ask outsiders as the profession itself may well have evolved into a suboptimal/too pragmatic (not to say ‘opportunistic’) treatment of such questions, given a constant pressure from suboptimal legal code & practice. In totally different areas I constantly see supposedly highly professional domain-bodies being utterly flawed from social/rational/economic perspective, and would easily expect this to be the case in your domain too.
Now, I’m assuming:
specifically your young girl case, and that you wager she’s more likely to be killed if you don’t treat her, while your Code would rather say she’s so far out of your area of expertise that you ‘legally’ should rather not treat her.
You are for good reasons certain enough (else of course try to acquire more stats/evidence first from whichever sources seem best: lit, fellows, domain experts, (acquaintances of the person?)..).
FWIW: I would find the following relatively natural or ‘rational’ - even if as a recipe maybe too high-level/trivial—though maybe I’m being too superficial and just stating a few all too obvious points and ignore too many subtleties of the domain..:
Talk—better even: write—to the surrounding persons that may be as much ‘authorities’ as can be. E.g.: parents, school teacher, maybe also consult some fellow (or upper) psychologists around you. Explain your rational and request explicit confirmation (/invite protests otherwise) *. Don’t fail to emphasize the expectation: ‘Without me, its not the optimal alternative, it’s NOTHING—however sad that is’
Adjust scope of this point 1. to the degree to which (i) pocketing such confirmations may ultimately be helpful evidence in a legal dispute at all, (ii) you do not inadvertently harm your cause: a single ignorant ‘dude, I think you ought NOT treat her’ might make the whole thing backfire: either make you not treat her due to the now heightened risk, or treat her at even greater risk than without any such confirmation. (Sneakily I could imagine variant: ask first orally & vaguely about views, then in positive cases ask those for written confirmation; though I guess sneaky ways won’t help much if push comes to shove)
Having pocketed these confirmations, assess what risks are if something happens, and thus the overall risk
Do the Cost/Benefit analysis ratio (all in: probabilities x ): Continue treating her iif expected benefits for her outweigh risk for you
Obviously you’re comparing (i) her benefit against (iia) your risk + (iib) risk for community if they loose you as good psychologist
(i) and (iib) could theoretically be compared easily, but (i) vs. (iia) is more tricky: You’re also comparing ‘life saved’ with lesser but more personal and still very relevant risks: your reputation, your job/career/income. (iib is of course relevant iif you think you’re making a significantly better contribution as psychologist than the next-best-person in charge might; if there’s in your village simply none else replacing you if you get banned, that might be more trivially confirmed to be a significant effect than if it’s institutionally clear there’d always be a psychologist on your seat even if you left)
When comparing her life saved against a reduction in your career risk I think you can only honestly ask yourself and without pressuring yourself: How do I feel about taking this risk to my career, for potentially helping her? What would be if it really happened that she dies while I was treating her? Maybe not trying to not be more altruistic than your gut feeling tells you there is better. Might you be bound to face such dilemmas many times in your hopefully long career, and you better not exhaust your appetite for ‘taking risk in helping’: Just always err slightly towards doing the ‘good’ thing but don’t try to force you to be a hero that as humans we usually simply aren’t?*
The one LW-y thing to add that comes to mind: Factor in AIs in all points above. Might soon ‘I’ve consulted Claude10.9 and he assured me it’s better’ suddenly count as better evidence than asking any human? ;-). Might Claude 11.1 anyway kick you out of job by 2028 at the latest so you can downweight your career risk from helping (though not downweight the risk of jailtime)?
* I fear that in practice as one gets older and less idealistic/more pragmatic, it would not be too rare that a simple self-serving bias creeps in, making also psychologists want to treat patients simply because that is how they earn their money (even if they might not internally frame it exactly that way)?! Please make sure you get to know many practitioners intimately and come back in 20 years to this blog and tell what your impression is :-)
First, my gut feeling is (w/o knowing anything about the domain really): You may well be exactly right to ask outsiders as the profession itself may well have evolved into a suboptimal/too pragmatic (not to say ‘opportunistic’) treatment of such questions, given a constant pressure from suboptimal legal code & practice. In totally different areas I constantly see supposedly highly professional domain-bodies being utterly flawed from social/rational/economic perspective, and would easily expect this to be the case in your domain too.
Now, I’m assuming:
specifically your young girl case, and that you wager she’s more likely to be killed if you don’t treat her, while your Code would rather say she’s so far out of your area of expertise that you ‘legally’ should rather not treat her.
You are for good reasons certain enough (else of course try to acquire more stats/evidence first from whichever sources seem best: lit, fellows, domain experts, (acquaintances of the person?)..).
FWIW: I would find the following relatively natural or ‘rational’ - even if as a recipe maybe too high-level/trivial—though maybe I’m being too superficial and just stating a few all too obvious points and ignore too many subtleties of the domain..:
Talk—better even: write—to the surrounding persons that may be as much ‘authorities’ as can be. E.g.: parents, school teacher, maybe also consult some fellow (or upper) psychologists around you. Explain your rational and request explicit confirmation (/invite protests otherwise) *. Don’t fail to emphasize the expectation: ‘Without me, its not the optimal alternative, it’s NOTHING—however sad that is’
Adjust scope of this point 1. to the degree to which (i) pocketing such confirmations may ultimately be helpful evidence in a legal dispute at all, (ii) you do not inadvertently harm your cause: a single ignorant ‘dude, I think you ought NOT treat her’ might make the whole thing backfire: either make you not treat her due to the now heightened risk, or treat her at even greater risk than without any such confirmation. (Sneakily I could imagine variant: ask first orally & vaguely about views, then in positive cases ask those for written confirmation; though I guess sneaky ways won’t help much if push comes to shove)
Having pocketed these confirmations, assess what risks are if something happens, and thus the overall risk
Do the Cost/Benefit analysis ratio (all in: probabilities x ): Continue treating her iif expected benefits for her outweigh risk for you
Obviously you’re comparing (i) her benefit against (iia) your risk + (iib) risk for community if they loose you as good psychologist
(i) and (iib) could theoretically be compared easily, but (i) vs. (iia) is more tricky: You’re also comparing ‘life saved’ with lesser but more personal and still very relevant risks: your reputation, your job/career/income. (iib is of course relevant iif you think you’re making a significantly better contribution as psychologist than the next-best-person in charge might; if there’s in your village simply none else replacing you if you get banned, that might be more trivially confirmed to be a significant effect than if it’s institutionally clear there’d always be a psychologist on your seat even if you left)
When comparing her life saved against a reduction in your career risk I think you can only honestly ask yourself and without pressuring yourself: How do I feel about taking this risk to my career, for potentially helping her? What would be if it really happened that she dies while I was treating her? Maybe not trying to not be more altruistic than your gut feeling tells you there is better. Might you be bound to face such dilemmas many times in your hopefully long career, and you better not exhaust your appetite for ‘taking risk in helping’: Just always err slightly towards doing the ‘good’ thing but don’t try to force you to be a hero that as humans we usually simply aren’t?*
The one LW-y thing to add that comes to mind: Factor in AIs in all points above. Might soon ‘I’ve consulted Claude10.9 and he assured me it’s better’ suddenly count as better evidence than asking any human? ;-). Might Claude 11.1 anyway kick you out of job by 2028 at the latest so you can downweight your career risk from helping (though not downweight the risk of jailtime)?
* I fear that in practice as one gets older and less idealistic/more pragmatic, it would not be too rare that a simple self-serving bias creeps in, making also psychologists want to treat patients simply because that is how they earn their money (even if they might not internally frame it exactly that way)?! Please make sure you get to know many practitioners intimately and come back in 20 years to this blog and tell what your impression is :-)