Ethical scenarios involving something illegal

[MedP111]

I'm very unsure about how to approach this type of MMI scenarios, so I want to spark a discussion here in hope of gaining some new insight. One classic example being, "If you caught your friend cheating on an exam in a class, would you report him?" Many people believe the only correct answer to give here is "yes", but I honestly believe that this is so situational and, in many cases, reporting the friend would absolutely be the wrong thing to do.

Would I just turn a blind eye on it and brush it off? Most likely not. I would talk to my friend about it and check to see if he needs any kind of help or resources to avoid this in the future. But reporting someone for cheating, depending on the school, can often have dramatic consequences, such as expulsion and a permanent record that forever dooms the student from his aspirations, and I really believe in second chances when it comes to things like cheating on an exam when no serious risk of third-party harm is involved.

This is the case at my school, where a friend of mine committed suicide last year after being reported and suffering the consequences (not to say that this was the only reason, but I'd imagine it likely played a role). I can't even bring myself to lie during the MMI and pretend that I will report my friend, because my stance on the moral wrongness of sticking with the rules all the time is something I hold very personally. Yet, if I answer honestly, I fear that I will get red flagged as a rebel who would break all the rules in medicine and wreck havoc on my patients.

This applies to many other cases as well, obviously. I can imagine a question being, "If you caught a family friend committing tax evasion for his business, would you report him?" The consequences of tax evasion can be quite heavy, from hefty fines to potential imprisonment. When someone running a small local store to make ends meet tries to get by with a couple extra bucks to feed his family a little better that year, I just don't have it in me to report him, and I'd even argue that it is wrong to do so. Yet, once again, this might only show me as someone who's willing to break the rules to stick by his own code of ethics, which I don't think medical schools are that fond of.

What do you think? Am I just a complete idiot in life for even holding these views? If you hold a stance similar to mine, what would you do in the MMI? Lie and tell them what they want to hear, even if you believe that it's straight BS? These scenarios just seem so tricky to me, because it seems to me that they're trying to evaluate how ethical you are as a person, yet I'd argue that you simply can't be much of an ethical person if you somehow believe that whatever is legal is necessarily always ethical.

Any input is appreciated! 

[jfdes]

I don't think the correct answer to give in your hypothetical situation is yes. Actually, I agree with your real answer, and I think that's the point - often times in life the situation is more complicated then a black and white "they did something wrong, so they need to be punished."

[rmorelan]

also you have to consider the remaining ethical principals. 

Ok so you cover up in effect for something illegal. There is a good chance if you do that as a matter of course you will eventually get caught etc. 

Now what? You damage the profession, you possibly will lose your licence which will prevent you from helping all future patients, and you just flushed all the money everyone around you poured into your education to create you. We are talking a huge sum of money from our tax system. 

So there you are bumping up against concepts of social justice and equality. 

In the case of the exam - you are allowing someone that for all you know has cheated every step of the way to get into medical school potentially. You are now ethically responsible for any negative consequences of that. Will the cheat again? Are they a substandard doctor? Who didn't get in because they did? Ha I am being a bit harsh here on purpose. Being ethically doesn't mean being nice

I am not saying you would do anything differently - the point is to make sure you consider all of the ethical principles to derive your conclusion. 

 

[indefatigable]

8 minutes ago, rmorelan said:

In the case of the exam - you are allowing someone that for all you know has cheated every step of the way to get into medical school potentially. You are now ethically responsible for any negative consequences of that. Will the cheat again? Are they a substandard doctor? Who didn't get in because they did? Ha I am being a bit harsh here on purpose. Being ethically doesn't mean being nice

 

Thought provoking points...  Just to put a spin on things - what happens if cheating is the norm, but getting caught isn't?  

[rmorelan]

9 minutes ago, marrakech said:

Thought provoking points...  Just to put a spin on things - what happens if cheating is the norm, but getting caught isn't?  

then the system has failed. Do you feel it is ethical to propagate a broken system? (ha)

(or let me phrase it differently from a ethical interview question - what would you expect a person of doctor material to do i that situation?)

[End Poverty]

Some additional points

- short term: it may appear that you are helping your friend/ family member but in the long run -  the situation might get worse or spiral out of control.

-Understand their side of story- encourage them to self-disclose. If they don't come forward, the situation might get worse. 

- If someone is evading taxes, it's a crime. If you don't tell the authorities, you would also be complicit in a crime.

- If you speak with them about the issue and you are trying to help them to change, but they are still cheating and/or evading taxes -- then you really need to re-evaluate their values as a person, and the fact that this person is not respecting your relationship..You have to do everything to help them change, but  if they are not changing, I believe b/c of my  own moral framework I can't keep this happening in the system and I will have to tell.

- If they are cheating: help them with time management + how to study properly + review things with them.

- If they are evading taxes: refer them to a social worker, tell them about income assistance programs, how to coupon/save money on groceries ..etc.

[indefatigable]

11 minutes ago, rmorelan said:

then the system has failed. Do you feel it is ethical to propagate a broken system? (ha)

(or let me phrase it differently from a ethical interview question - what would you expect a person of doctor material to do i that situation?)

Cheating is a broad term (much more than exams).. but from a recent survey:

"86 percent claimed they cheated in school.
54 percent indicated that cheating was OK. Some said it it is necessary to stay competitive.
97 percent of admitted cheaters say they have never been caught. 
76 percent copied word for word someone else's assignments..
12 percent indicated they would never cheat because of ethics."

I think context is key in this kind of situation..  it might be that everyone does cheat.  In that case, it's a little more tricky and I don't think there's a clear cut answer regarding reporting.. it's pretty much a whole different question.

[rmorelan]

7 minutes ago, marrakech said:

Cheating is a broad term (much more than exams).. but from a recent survey:

"86 percent claimed they cheated in school.
54 percent indicated that cheating was OK. Some said it it is necessary to stay competitive.
97 percent of admitted cheaters say they have never been caught. 
76 percent copied word for word someone else's assignments..
12 percent indicated they would never cheat because of ethics."

I think context is key in this kind of situation..  it might be that everyone does cheat.  In that case, it's a little more tricky and I don't think there's a clear cut answer regarding reporting.. it's pretty much a whole different question.

I guess my point is there may be complexities in context in the real world - but there isn't as much for an interview question. The examiner is going to hold you to a higher standards than the average person. 

That doesn't mean you just say I would turn in my friend etc and wash your hands of things. You never do that in any ethical scenario.  

[indefatigable]

2 minutes ago, rmorelan said:

I guess my point is there may be complexities in context in the real world - but there isn't as much for an interview question. The examiner is going to hold you to a higher standards than the average person. 

That doesn't mean you just say I would turn in my friend etc and wash your hands of things. You never do that in any ethical scenario.  

I think we're on the same page

[MedP111]

43 minutes ago, End Poverty said:

- If someone is evading taxes, it's a crime. If you don't tell the authorities, you would also be complicit in a crime.

- If you speak with them about the issue and you are trying to help them to change, but they are still cheating and/or evading taxes -- then you really need to re-evaluate their values as a person, and the fact that this person is not respecting your relationship..You have to do everything to help them change, but  if they are not changing, I believe b/c of my  own moral framework I can't keep this happening in the system and I will have to tell.

So would you say that it's ok to first talk to the person to try to get them to change first, and only tell later if it's not working? I agree that if my friend is revealed to be a serial cheater even after I tried to help, or if the family is still evading taxes after I tried to get them to stop, then I will feel rather obligated to report.

But I'm very conflicted when it comes to the first violation. If your friend does agree to stop (and does stop), would you still feel the need to report or to get them to self-disclose because you feel that, no matter what they do after, the fact of the matter is that they still did cheat and that's enough to warrant all the consequences? In the case of the family evading taxes, even if they do stop afterwards thanks to your recommendations, it doesn't change the fact that they still did commit a crime, so would you tell authorities/encourage them to self-report anyway? I'm a strong believer in second chances, and I understand the law to be not quite so.

Being complicit in a crime doesn't ever sound like a good position to take... But in my case at least, to be perfectly honest, an unwillingness to be complicit in a crime would be mostly a selfish decision (i.e. I don't wanna get in trouble because of you!) rather than a principled belief, and so I find it hard to defend a strict "I HAVE to report you" stance without coming off as a completely self-concerned individual.

Thank you to all for the very good points raised! I hope to hear even more, I'm definitely gaining a lot from this  

[Bambi]

If you caught your friend cheating on an exam, would you report him? Is it a mid term, a final, is it in med school, is it a licencing exam that will allow him to serve the public as physician? Do the additional questions impact upon your potential answer?

What if this friend came to you in an agitated state with a box, asking you to hide it or get rid of it for him (without opening the box) and from the weight, you know there is something in the box. You then hear on the news the next day that his father was murdered with gunshots to the head. What do you do? Do you get rid of the box, do you look inside to find a gun or do you hide it? Or, do you go to the police or tell your friend if he does not go to the police, you will? And if he asks for the box back, do you return it to him - in the knowledge that he will likely dispose of the box himself, even if he tells you he will bring it to the police?

Why does my last example raise the stakes? Is it because you fear you will be an accessory after the fact to murder? Does you own complicity and potential criminal conviction and jail time for you with ripple consequences for the remainder of your life suddenly give you a greater social conscience where your friend's interests are less important?

When the stakes are raised with immense consequences upon you, suddenly, you are able to see the issues with greater clarity. So, perhaps you are prepared to overlook a friend stealing $10 that you know about, and you are only concerned when the quantity of money stolen becomes $100,000 - and because of the potential consequences upon yourself!

Yes, not wanting to be complicit in a crime is a decision based upon self-interest, not for any social, moral or ethical reason. I do know that I would never be prepared to compromise my integrity for even my best friend; it can be a slippery slope if you take into account the so-called relative value of the offense in making a decision of what to do. You either have integrity or you don't. If I know I cannot trust you in matter of lesser importance, I know you are not a trustworthy person period. And then, you are no better than the cheater, except for the so-called (poor) self-justification in your own mind.

[MedP111]

11 minutes ago, Bambi said:

If you caught your friend cheating on an exam, would you report him? Is it a mid term, a final, is it in med school, is it a licencing exam that will allow him to serve the public as physician? Do the additional questions impact upon your potential answer?

What if this friend came to you in an agitated state with a box, asking you to hide it or get rid of it for him (without opening the box) and from the weight, you know there is something in the box. You then hear on the news the next day that his father was murdered with gunshots to the head. What do you do? Do you get rid of the box, do you look inside to find a gun or do you hide it? Or, do you go to the police or tell your friend if he does not go to the police, you will? And if he asks for the box back, do you return it to him - in the knowledge that he will likely dispose of the box himself, even if he tells you he will bring it to the police?

Why does my last example raise the stakes? Is it because you fear you will be an accessory after the fact to murder? Does you own complicity and potential criminal conviction and jail time for you with ripple consequences for the remainder of your life suddenly give you a greater social conscience where your friend's interests are less important?

When the stakes are raised with immense consequences upon you, suddenly, you are able to see the issues with greater clarity. So, perhaps you are prepared to overlook a friend stealing $10 that you know about, and you are only concerned when the quantity of money stolen becomes $100,000 - and because of the potential consequences upon yourself!

Yes, not wanting to be complicit in a crime is a decision based upon self-interest, not for any social, moral or ethical reason. I do know that I would never be prepared to compromise my integrity for even my best friend; it can be a slippery slope if you take into account the so-called relative value of the offense in making a decision of what to do. You either have integrity or you don't. If I know I cannot trust you in matter of lesser importance, I know you are not a trustworthy person period. And then, you are no better than the cheater, except for the so-called (poor) self-justification in your own mind.

You raise a number of points. I will try to address some of them.

1) Obviously, the additional considerations would matter, quite a bit. If my friend cheated on a licensing exam that would allow them to be in charge of patients, while I will still talk to them about it first, it's clear to me that the only choice at the end here is to report them, as there is too much at stake should I not. I don't find this case to be very difficult to wrap my head around. It actually becomes much harder when you don't take it to the extreme: suppose it's just an exam in college. There's no immediate serious third-party harm or risk that will come of this act if it is not perpetuated. And so, if the person can be talked into stopping, I will definitely go that route instead of turning them in to face consequences that I personally think of as too heavy.

2) If a friend asks me to hide a box and I then learn that their father was murdered... I don't find this case to be conflicting at all. Of course I will turn the box in to the police. I feel a strong obligation to do so, even if some fairy guarantees me that I will never be caught should I decide to keep hiding it. The person has murdered. That is sufficient. The only thing I would fear in this situation is that this person might threaten me into complicity, but that's a whole other discussion.

3) You are right that acting out of fear of complicity alone is entirely devoid of integrity. That's wholly my point, however. In some of these ethical scenarios, it is my personal belief that the only real reason there is for reporting is because I wouldn't want to be complicit to the act, for my own sake. Yet, acting this way would clearly be purely self-interested, and not something I would do, and not something I would incorporate in an MMI answer. Hence why, in some of these scenarios, I would personally agree with being complicit with the act (e.g. not reporting on my friend who cheated) although this also sounds wrong just by virtue of going against established norms. This takes us back to the very reason why I feel so lost on some of these cases in the first place. I envy you for having such a clear sense of integrity. But in my experience, integrity and following the rules all the time can sometimes come apart, as my values, which I care very much about living by in my life, don't always agree with what society tells me I should do. I believe the latter applies to you as well, however, so I'm interested in hearing more about how you manage to see these issues without the same conflict that haunts me.

[End Poverty]

2 hours ago, MedP111 said:

 

Being complicit in a crime doesn't ever sound like a good position to take... But in my case at least, to be perfectly honest, an unwillingness to be complicit in a crime would be mostly a selfish decision (i.e. I don't wanna get in trouble because of you!) rather than a principled belief, and so I find it hard to defend a strict "I HAVE to report you" stance without coming off as a completely self-concerned individual.

Thank you to all for the very good points raised! I hope to hear even more, I'm definitely gaining a lot from this  

 You have to report someone's crime, because as a civilian/citizen, just like you have many rights, you also have the responsibility and the duty to report crimes/illegal issues  I don't think it is a very good idea to strictly defend the point: " I have to report you b/c I don't want to face negative repercussion". It is a point that you definitely need to consider in your MMI response, but it should not be the main point --> b/c you don't want to appear as someone who is only doing it to protect yourself ( you won't be displaying any altruism if that's your main reasoning).

When someone does something wrong, they have to rectify their mistake b/c that is how they show they are truly remorseful. I would encourage them to self-disclose/rectify their mistake even if they are first time offenders. If their mistake negatively impacted someone then they have to rectify their mistake.

 

[SunAndMoon]

22 minutes ago, End Poverty said:

 You have to report someone's crime, because as a civilian/citizen, just like you have many rights, you also have the responsibility and the duty to report crimes/illegal issues 

 

An absolutely horrible ethical justification that would shield you from moral blame in any state/law-backed immoral act. 

Do you think those who denounced Jews so the Germans could come pick them up were morally right because of their "responsibility and duty to report"? 

[End Poverty]

10 minutes ago, SunAndMoon said:

An absolutely horrible ethical justification that would shield you from moral blame in any state/law-backed immoral act. 

Do you think those who denounced Jews so the Germans could come pick them up were morally right because of their "responsibility and duty to report"? 

Your arguments are completely true, in a different situation. I was speaking in the context of tax evasion in Canada.  I was answering the OP's question, not making a general ethical statement. In this case,  I am making the assumptions that the tax rules/ regulations are actually fair and in place to protect everyone and we have responsibility to protect the integrity of the system  But, you know what,  to be completely honest, I am not completely sure if the tax system is completely fair as I don't have enough understanding of tax system.

 

[SunAndMoon]

3 minutes ago, End Poverty said:

In this case,  I am making the assumptions that the rules/ regulations are actually fair and in place to protect everyone

 

Right - in this case the assumption is debatable, and if we agree to make that assumption we would have to discuss the harms of reporting the tax evader and whether those harms are disproportionate (a corporation or a billionaire evading taxes =/= your low-to-middle class neighbor). 

 

What I was trying to point out, and this applies both to the situation I described and yours, is that by relying on an obligation or duty to report, you simply reject any form of thinking about the ethics of a situation and defer to the obligation. It's basically just a cop out

[End Poverty]

10 minutes ago, SunAndMoon said:

 

What I was trying to point out, and this applies both to the situation I described and yours, is that by relying on an obligation or duty to report, you simply reject any form of thinking about the ethics of a situation and defer to the obligation. It's basically just a cop out

My argument in regards to duty to report is one argument to add to the OP's points amongst many arguments that were already mentioned. I agree with you, the duty argument is an auxiliary point and it should not be the main point at all. I am trying to add different perspectives, I was not answering the question fully at all :). 

[MedP111]

38 minutes ago, End Poverty said:

 You have to report someone's crime, because as a civilian/citizen, just like you have many rights, you also have the responsibility and the duty to report crimes/illegal issues  I don't think it is a very good idea to strictly defend the point: " I have to report you b/c I don't want to face negative repercussion". It is a point that you definitely need to consider in your MMI response, but it should not be the main point --> b/c you don't want to appear as someone who is only doing it to protect yourself ( you won't be displaying any altruism if that's your main reasoning).

When someone does something wrong, they have to rectify their mistake b/c that is how they show they are truly remorseful. I would encourage them to self-disclose/rectify their mistake even if they are first time offenders. If their mistake negatively impacted someone then they have to rectify their mistake.

 

Perhaps I'm just a horrible person, but the whole "Sorry, no matter what you say and no matter what the situation is, I just HAVE to report you because it is my responsibility to do so as a civilian." line of argument simply doesn't resonate with me at all. I think it might serve as a secondary reason when you already have a main reason that truly drives you to report, but in the absence of such a main reason, this doesn't stand well on its own.

Suppose the following scenario for fun: Tom is struggling to make ends meet, and despite working 60 hours/week is sad every day that he can't even make enough to feed his kids right. One year, he decides to commit tax evasion to save a couple extra grands so that his kids might afford college in a few years, which he thinks will give them a real opportunity, something he's never had. If caught, Tom will face a fine that would ruin his entire family and years of imprisonment; forget college, these kids won't even be able to afford a toy ever again. You know Tom did what he did, and confront him about it. You raise all the risks that come from this, why this is wrong, etc., and he agrees to stop and to look for other options instead. But then, before leaving, you tell him, "But Tom, buddy, even if you're never going to do this again, I'm still going to report you because you already did what you did and that's the only way for you to show remorse and I have a duty as a civilian to report you! This is the law, and this law is there for a good reason, and I have integrity, so I must do what I must."

I just don't think that's something I would ever say, because that just sounds so off, and I honestly hope I'm not the only one who feels this way. This man will stop. At this point, the only consideration is whether he should get punished for what he's already done. And here, it seems to me that the harm his family would suffer is simply too great in comparison with the harm society has taken because of his actions. So, the only reasons left for reporting him would be, 1) I don't want to risk complicity because I have to watch out for my own back, and 2) I just have to because it's my duty as a civilian, period. None of these sounds very right to me. What would you do here?

Addressing another point you made, self-reporting isn't the only way to truly show remorse. Perhaps Tom truly is ashamed of his actions here. Yet he simply can't afford to self-report, because the consequences on his family are simply too high. One might say that "it's better to self-report now than to be caught later", but this detracts from the real issue at heart and can be dismissed if we assume, for the sake of argument, that the risk of a very small business getting caught is incredibly low.

Thanks for all your time by the way, it's much appreciated

[MedP111]

49 minutes ago, SunAndMoon said:

Right - in this case the assumption is debatable, and if we agree to make that assumption we would have to discuss the harms of reporting the tax evader and whether those harms are disproportionate (a corporation or a billionaire evading taxes =/= your low-to-middle class neighbor). 

This ties to a point I made earlier, but I'm really interested in hearing your thoughts on this so I'm quoting you specifically haha

Building from what you said, suppose you do consider these harms and your conclusion is that, indeed, the harms are disproportionate. What then? It's likely that some people will judge the harms as being disproportionate ("Woah, these consequences are way too heavy for an action that, while illegal, is in a way understandable and that doesn't cause any serious harm to anyone else.") while some others, not so ("They knew the rules, so they only have themselves to blame, regardless of what the consequences are!"). These are different viewpoints that are hard to conciliate, and that depend fundamentally on your own values, i.e. it's not as though you can have complete faith that your judgment is actually "correct". Would you decide to stick with your own judgment and "go rogue", so to speak? Or would you think it wiser to always defer to an external force that you see as greater than yourself (not implying religion here haha) to make your ultimate decision?

[End Poverty]

32 minutes ago, MedP111 said:

 

Suppose the following scenario for fun: Tom is struggling to make ends meet, and despite working 60 hours/week is sad every day that he can't even make enough to feed his kids right. One year, he decides to commit tax evasion to save a couple extra grands so that his kids might afford college in a few years, which he thinks will give them a real opportunity, something he's never had. If caught, Tom will face a fine that would ruin his entire family and years of imprisonment; forget college, these kids won't even be able to afford a toy ever again. You know Tom did what he did, and confront him about it. You raise all the risks that come from this, why this is wrong, etc., and he agrees to stop and to look for other options instead. But then, before leaving, you tell him, "But Tom, buddy, even if you're never going to do this again, I'm still going to report you because you already did what you did and that's the only way for you to show remorse and I have a duty as a civilian to report you! This is the law, and this law is there for a good reason, and I have integrity, so I must do what I must."

 

You are overthinking the situation. I work with  very low income women who evaded taxes, but had to self-disclose fraud ( minor fraud). By correcting their taxes voluntarily, they avoided penalties and persecution. Most of the time, if the person is truly low income, they would face no penalty if they self-disclosed and rectified the situation.

 

BUT if they decide to not disclose, and during the vetting process, it gets discovered that they lied --> there would be more repercussions. I believe that it is in their best interest to self-disclose.

[MedP111]

1 hour ago, End Poverty said:

You are overthinking the situation. I work with  very low income women who evaded taxes, but had to self-disclose fraud ( minor fraud). By correcting their taxes voluntarily, they avoided penalties and persecution.  

Ah, this makes sense.

Perhaps tax evasion was a bad example for the discussion then. But this matters very little; suppose a similar situation but in which there is no convenient work-around that allows one to undo their crime without any kind of penalty or prosecution (a reasonable assumption, I hope). What then?

Edit:

Since you edited your original post, here are my edits in response as follow-up:

1 hour ago, End Poverty said:

Most of the time, if the person is truly low income, they would face no penalty if they self-disclosed and rectified the situation.

 

BUT if they decide to not disclose, and during the vetting process, it gets discovered that they lied --> there would be more repercussions. I believe that it is in their best interest to self-disclose.

1) Again, assume serious penalty in the case of disclosure. I'm playing the devil's advocate here for the sake of advancing the argument to where it truly matters. In short, what if the harms of reporting appear disproportionate to you?

2) My reply to this argument which I had anticipated earlier: "One might say that "it's better to self-report now than to be caught later", but this detracts from the real issue at heart and can be dismissed if we assume, for the sake of argument, that the risk of a very small business getting caught is incredibly low."

So now, we have no choice but to face the crux of the issue. What now?

[Bambi]

1 hour ago, SunAndMoon said:

An absolutely horrible ethical justification that would shield you from moral blame in any state/law-backed immoral act. 

Do you think those who denounced Jews so the Germans could come pick them up were morally right because of their "responsibility and duty to report"? 

There are laws that are illegal even if imposed by the state. State murder and on an industrial scale and stating, "I followed orders" is no excuse even if you did it under threat of death. Reporting Jews under your example is immoral and reprehensible and at a minimum is complicity to murder. 

It is impossible to know that another committed tax fraud, at most, you have hearsay information from another source, for sure you do not have the evidence. I would cut off anybody who is about to disclose such a secret. I don't need to know another person's secrets (professional secrecy aside). It becomes a burden and it is no longer a secret. If you have a secret, keep it to yourself. I do not want to know the secrets of my friends, these are none of my business. However, being a witness to an illegal or immoral act is another matter.

Recently, a lawyer told me of a case he handled where he learned as a result of professional communication that a third party was regularly selling drugs to children at a specific school. He dearly wanted to report this to the authorities. He went to the Bar Association who informed him that as he learned this information through professional communication (and even though it did not involve his client), he was prohibited from passing on this information to the police. 

[Butterfly_]

21 minutes ago, Bambi said:

 

Recently, a lawyer told me of a case he handled where he learned as a result of professional communication that a third party was regularly selling drugs to children at a specific school. He dearly wanted to report this to the authorities. He went to the Bar Association who informed him that as he learned this information through professional communication (and even though it did not involve his client), he was prohibited from passing on this information to the police. 

 

Unbelievable. Selling drugs to children. I hope he gets caught and punished.

[SunAndMoon]

1 hour ago, MedP111 said:

This ties to a point I made earlier, but I'm really interested in hearing your thoughts on this so I'm quoting you specifically haha

Building from what you said, suppose you do consider these harms and your conclusion is that, indeed, the harms are disproportionate. What then? It's likely that some people will judge the harms as being disproportionate ("Woah, these consequences are way too heavy for an action that, while illegal, is in a way understandable and that doesn't cause any serious harm to anyone else.") while some others, not so ("They knew the rules, so they only have themselves to blame, regardless of what the consequences are!"). These are different viewpoints that are hard to conciliate, and that depend fundamentally on your own values, i.e. it's not as though you can have complete faith that your judgment is actually "correct". Would you decide to stick with your own judgment and "go rogue", so to speak? Or would you think it wiser to always defer to an external force that you see as greater than yourself (not implying religion here haha) to make your ultimate decision?

It's really hard for me to give you an answer in the specific context for which you ask the question: ie., something that you are evaluated on in an MMI (for instance). 

In real life, I would not tell. In the MMIs, I am not sure what they are trying to get you to say, but it seems like a variant of "your friend cheated on an exam". Some variants that some schools may like to put on their MMIs are far too extreme, ridiculous, irrelevant to a future medical practice, and really hard to evaluate. There is no easy or straightforward answer and both points can be defensible (however I feel like they want to see someone who would lean towards reporting, as disgusting as it is in certain contexts).

 

16 minutes ago, Bambi said:

There are laws that are illegal even if imposed by the state. State murder and on an industrial scale and stating, "I followed orders" is no excuse even if you did it under threat of death. Reporting Jews under your example is immoral and reprehensible and at a minimum is complicity to murder. 

It is impossible to know that another committed tax fraud, at most, you have hearsay information from another source, for sure you do not have the evidence. I would cut off anybody who is about to disclose such a secret. I don't need to know another person's secrets (professional secrecy aside). It becomes a burden and it is no longer a secret. If you have a secret, keep it to yourself. I do not want to know the secrets of my friends, these are none of my business. However, being a witness to an illegal or immoral act is another matter.

Recently, a lawyer told me of a case he handled where he learned as a result of professional communication that a third party was regularly selling drugs to children at a specific school. He dearly wanted to report this to the authorities. He went to the Bar Association who informed him that as he learned this information through professional communication (and even though it did not involve his client), he was prohibited from passing on this information to the police. 

I agree with you until your arbitrary differentiation based on your witnessing or not an illegal or immoral act - this does not change anything about the act and whether it is the kind of act that is right to be reported or not, which is imo a crucial point here. 

I understand that you may be less of a snitch (sorry - lack of a better word here as the situation some interviewers put you in essentially ask you to be a snitch, or refuse to be one) if you report something you accidentally witnessed as opposed to actively looking for things to report, but in some situations, you can still be blameworthy and responsible for the negative consequences of the reporting of something that is not "that bad", especially if those consequences are greatly out of proportion with the act that you are reporting.

In other words these scenarios are extremely heavy, strongly depend on values, may be asking of you to consider different courses but ultimately require you to blindly follow rules (my hypothesis, have never been on admissions committee), are too complex for any medical school interview. 

As to your example of the lawyer, this is exactly why i think that abiding by  professional deontology/laws is the substitution of your own ethical decision making for a set of rules. This person, IMO, had two choices:
(a) Consider that privileged communication is paramount to the profession of law, and therefore accept that he cannot report anything a client says and that moral imperative trumps all other moral imperatives.

(b) That, in this context, his professional moral imperative is an obstacle to preserving children of a serious danger, and report it to the police (and risk consequences to his career or even disbarment), or report it anonymously somehow. 

I don't think this is going to be a popular opinion but it's my opinion...

[Bambi]

By virtue of the legal ethics imposed upon him, he was not able to report this man. Although he considered the possibility of reporting him anonymously, in order for it to be credible and followed up, this was not an option. Had he made the report giving his name, he would have been disbarred and unable to resume practice as a result of a serious breach of confidence.

For the MMI scenario that they throw at you, your thought processes, analysis and how you get to your conclusion are more important than your actual answer
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