Comment by Barrin92

7 days ago

I always found that case a bit odd. For one he was blogging under his real name and had made his medical practice known, so you could just google him.

It was upending his psychiatry practice because he blogged, albeit in anonymized fashion, about his patients without disclosing it to them which I'd say is unethical but at the very least in the interest of his patients to be made known to them. I would be pretty pissed if I recognized something I told my psychiatrist on an internet blog. Frankly given how strongly one has to consent to even legally process clinical data I've never been sure if that was at all legal.

When someone's identity is in the public interest an investigative journalist isn't doxxing anyone, they're doing their job. Both true for Nakamoto and arguably Scott

He was not blogging under his real name. Scott Alexander is not his real name.

  • It's his first and middle name. At least that's what he said in the post about shutting down the blog.

  • It's most of his name. Long before his full name became common knowledge, you could already Google "Scott Alexander psychiatrist" and find him almost instantly.

    • That part of things is what really made this entire argument all apart of me.

      There are ~50k psychiatrists in the US. Roughly, 1 in 10k people in the US is named Scott. Mathematically, that means knowing "Scott is a psychiatrist" brings you down to ~5 people. Even if we assume there's some outlier clustering of people named Scott who are psychiatrists, we're still talking about some small number.

      Surely adding in the middle name essentially makes him uniquely identifiable without an other corroborating information.

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> I always found that case a bit odd. For one he was blogging under his real name and had made his medical practice known, so you could just google him.

Cade Metz wrote the article under his real name, and his home address is public information, but presumably he wouldn't appreciate it being published on the internet. Why is that any different?

It’s legal to publish anonymous patient data, doctors do it frequently e.g. in “case studies”. As long as it can’t be traced back to the patient I don’t see why they should care (I wouldn’t). And since it increases public knowledge (e.g. how to treat future patients) I think it’s not only ethical, but should be encouraged.

Doxxing also increases public knowledge, but knowing who’s behind some online pseudonym is much less useful than patient anecdotes (what would you do with the former? Satisfy your interest (or what else do you mean by “public interest”)?). Moreover, unlike anonymous patient data, it has a serious downside: risking someone’s job, relationships, or even life.

  • Case studies are done with consent, typically. That’s pretty different.

    • In principle, anonymized case studies do not require consent and historically, they were often published without. Without personally identifiable information, this is and always has been 100% legal. But in modern practice, many journals acknowledge that making a case fully anonymous in the age of the internet might not even be possible without taking away everything noteworthy, so they require some form of consent nowadays.

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    • I don’t know how typical it is, but HIPAA explicitly doesn’t cover patient data after anonymization, and anecdotally I’ve had an anonymous case study published about me without my consent (although I was notified after).

The NYT has no authority to dox people. If they or anyone believed that SSC was acting unethically or illegally, that should be processed through proper legal or ethical channels, which exist for a reason. The solution is not that NYT should abuse their power to skip those channels.