Sandeep Jauhar is a cardiologist, the author of “Doctored: The Disillusionment of an American Physician” and “Intern: A Doctor’s Initiation.”and a contributing op-ed writer for the New York Times. He recently penned a column for the paper that raised concerns about threats to doctor-patient confidentiality, specifically from the case, in Washington state, of Volk v. DeMeerleer.
Howard Ashby, a psychiatrist, was sued after his patient, Jan DeMeerleer, shot and killed an ex-girlfriend and her 9-year-old son before shooting himself. The estate of the victims, Rebecca and Phillip Schiering sued Dr. Ashby, alleging that he breached a duty to warn DeMeerleer’s victims even though the killer had made no specific threats toward the Schierings during his treatment. Last year, however, that judgment was reversed by an appeals court, which held that doctors could be required to warn “all foreseeable victims” of their potentially dangerous patients in their care.
It’s a terrible decision, and Jauhar does a good job explaining why. Unfortunately, he also writes this..
“I once took care of a business executive in the emergency room who had hired call girls during a weekend drug binge. When he saw a police officer outside his room, he quietly handed me an envelope containing a large amount of white powder. I wasn’t sure what to do with it, so I discarded it. For the next several hours the patient eyed me suspiciously, probably wondering whether I had ratted him out. But it never occurred to me to do so.”
Well, it should have. Confidentiality is one thing, assisting in a crime is another. The Hippocratic Oath says“What I may see or hear in the course of treatment, I will keep to myself.” That only means, however, that doctors who learn about criminal activity a patient may be involved in is bound not to report it (lawyers have the same obligation). Jauhar did more than not report criminal activity; he participated in it. He crossed the line by disposing of contraband.
Renowned Georgetown Law Center legal ethicist Steve Lubet neatly explained where the doctor went astray in his letter to the Times;
To the Editor:
Dr. Sandeep Jauhar undermines his argument for physician-patient confidentiality by referring to an instance in which he accepted an envelope of white powder, presumably drugs, from a patient and “discarded” it to avoid discovery by the police.
Hiding evidence of a crime isn’t confidentiality; it’s obstruction of justice. There is nothing about one’s status as a physician — or a lawyer, for that matter — that requires or excuses the possession or concealment of contraband.
Source: Legal Ethics Forum