DOCTORS AND THEIR PATIENTS

Dominion, Volume 14, Issue 306, 20 September 1921, Page 9

DOCTORS AND THEIR PATIENTS

PROFESSIONAL SECRETS B.M.A STRONG AGAINST DIVULGENCE At the annual meeting at Newcastle of the British Medical Association, the governing body, under the chairmanship of Dr. Garstang, of Altrincham, debated nt considerable length the question of professional secrecy. Dr. Langdon Down, of Hampton Wick, the chairman of the Central Ethical Committee, urged that the following recommendation of the council bo adopted: "That when a medical practitioner refuses to divulge information which ho has obtained in the exercise of his professional duties in such circumstances as the following:— (a) In a Court of Lew, when n Court has ruled that information so obtained muat be disclosed 1 ; (b) When it is already provided by Act of Parliament that ha muat do so, for instance, in the notification of certain diseases. "Such action must be taken entirely On his own responsibility, and the association cannot be expected to support him or protect him from consequences he may incur in so doing." The resolution further stated that re•istanoe would be given by the association to nny further encroachments cn professional secrecy. Dr. Dain, of the Birmingham Central District, proposed l as an amendment that the association use all its power to support a member who refuses to divulge,' without the patient's consent, information obtained in the exercise of his professional duties. Dr. Dain said it was thought tho council would have taken a stronger course than they had done in not divulging. The public were behind the doctors. Their view was that the doctor should never, under any circumstances, tell what hie patient had told to him. In a good ninny States of the United States the doctor was not only not compelled to give evidence, but ho was not allowed to give it. In Erance the doctor was punished if he gave such evidence, anil in Now Zealand tho doctor was protected by law from divulging in civil cases. "I do not know." he continued, "why n person should incriminate himself for Information given to his doctor any more than for information given to the priest. (Hear hear.) I think, at any rate, we might get protection for civil cases and for divorce cases which so frequently occur. The penalty for refusing is that a doctor may bo committed’for contempt, and may be in gaol for the remainder of liis life. I don't know of a case in which a doctor has been committed, but I think wo should stand up and tako the risk. It is only by doing that that we can make the position good, and the association should stand behind us in setting up a proper standard of professional secrecy." An Injury to the Community. Dr. Parker (Bristol): —There aro utilitarian grounds on which we should take our stand. If wo aro not allowed to keep our patients’ secrets, tho people suffering from certain diseases must go untreated. That would be an injury to the community. The judges have asked us to reveal Information in order to save them trouble in doing their job. They aro there to elucidate tho circumstances of tho case. It is not for them to ask us to commit a moral crimo in order to make their job easier. (Hear, hear.) Dr. Macdonald (Taunton), supporting tho amendment, said the association could not spend money in supporting the man who took up a stand in refusing to divulge. Lawyers were not asked to answer such questions. A medical man who stood up for tho dignity of his profession and the sanctity of his relationship with his patient had got to take the risk of contempt. he continued, “I do not think that any court would take that contempt very far. as the outcry against it would be too great.” Dr. Fleming (Stratford-on-Avon) said without tho confidence of patients the practice of medicine -would be seriously crippled 1 . Was it better that an occaeionpl crime should bo undetected and unpunished |f a medical man refused to give evidence, or that disease should b» untreated because tho doctors did not have the confidence of their patients? Which would- he worse? "What an enormous number of crimes would be proved and punished," declared Dr. Fleming, "if the solicitor was compelled to give the information which he received from his client in confidence. The suggestion is inconceivable on the part of a solicitor. Why not on the part of the medical man? Is it likely that a Parliament, overridden by lawyers, is going to give ns tho protection wo seek? We should make for ourselves by persistence the law which the solicitors nnd tho priests have made for themselves, and which nobody questions.’’ (Hear, hear.) Broken Laws Accepted by ths Governmerit. Dr. Shahan (Portsmouth) thought tho action of the council had been weak. "Laws have to be broken,” he exclaimed, "and when laws are broken they are accepted by tho Government. Look at tho conference which is now taking place in London. If you only stand firm, then the Government will climb down. If a strong medical man were respectfully to say 'I decline to give evidence,’ and if ho were committed, there would be such a fuss that the alteration would soon be made.”

Dr. Brackenhury (Middlesex) said ha TFas entirely with the preceding speakers in spirit.' but on a question of this kind it was necessary to make nice distinctions. Tho position of the medical man was not that of tho lawyer or tho priest. The lawyer was consulted spemfically for the purpose of litigation. Tho priest was consulted as a moral adviser, but he was only protected when it was done in tho confessional. In tho great majority of cases ho thought the power of the association should bo behind tho man who refused to divulge, but ho could see cases in which tho public would be against the doctor if ho refused. Dr. R. A. Bolani, chairman of tho council, remarked that it would not bo tolerable if they wore called to give information of what happened in Government venereal clinics. He suggested as a loophole that the association should direct the council to fake immediate steps to establish the position that a medical practitioner should not be compelled to divulge in a court of law any information he received as a professional adviser. Dr. Rowlette (Dublin) said tho military authorities in Ireland issued nn order that the name and address of every patient treated in certain hospitals and tho nature of the injuries should bo re]x»rt c d to I horn from fkiy to day. Tho penalty was imprisonment. “Hp to tho present.’’ he sail, "no proceedings have been taken to enforce the < rdor, though not a single medical man in Ireland has obeved it. Two doctors have been in gaol and released without being charged with any offence. I know of nothing against them ex-ept that they did not obey the orders." Dr. Haslip (tho treasurer of the association).: Tiie priests refuse to speak, and it is quite open to us to follow that example. That is tho only way you can meet tho question. Legal Difficulties. Mr. Hempsnn (the solicitor; pointed to difficulties, particularly in regard Io crime committed in certain circumstances which might arise if a hard and fast line were drawn. There was no protection in France. Dr. Langdon Down believed they were claiming a thing that was not necessary anl that they did not really need. It. was assorted that certain things war© derogatory to them, but in. his view

what they should say was that they should not bo compelled to not ns conscious informers. They must bo careful not to be placed in n position where (hey would shield wrongdoers. The amendment, ns substantive motion, was carried b- on overwhelming majority with the addition of the words, "except where it is already provided by Act of Parliament that he must do so." The chairman said that as sufficient notice had not been given, the motion could not become the policy of the association at that meeting, but was an expression of opinion of the representative meeting which would have great moi al weight. ’ i.