The Doctor’s Secret

Sun (Auckland), Volume III, Issue 855, 26 December 1929, Page 8

The Doctor’s Secret

When Medicos Should Speak

TORN between aiding in the administration of justice, and the sacred trust of their patients, medical men all over New Zealand have on occasions been presented with the delicate problem of divulging or retaining confidential information. Time after time the law has decided that when the course of justice is involved a doctor enjoys no privilege in respect to information given him by a patient. But the question that now arises is: “To what extent should a doctor become an informer to the police?”

This conflicting circumstance has been brought before the minds of the profession by the remarks of a coroner in Dunedin, who established a distinction between a hospital doctor and a private practitioner insofar as the voluntary disclosure of information is concerned. This case, along with many others, left no doubt that a doctor must tell when called as a witness and asked specific questions. But should he inform? Members of the profession in Auckland and elsewhere would like to have that question decisively answered. Precedent and popular authority indicate that when the call of duty is strong he should tell. Yet where is the line to be drawn between this disclosure and the sacred confidence of his patient? Cases of poisoning, wounding and serious assault, as well as cases involving questions of divorce or the legitimacy of offspring, may be materially affected by the answers of medical men upon aspects which have been the subject of private information. It often happens upon a criminal count that th.e reply made by the accused person to a • doctor’s professional question is the sole evidence upon which a conviction may be based. Information in such circumstances is given when asked for. Frequently a protest is made; then the law is obeyed. DEATH THREATENS

A doctor in England some time ago possessed confidential information which touched directly upon a divorce case. He was forced to divulge his conversation with the patient under pain of being charged with contempt of court.

The most common class of case in which this question is raised in New Zealand is that of illegal operations performed upon women. As far back as 1895 the Royal College of Physicians in England appointed a committee to deal with the specific question, and set out a hypothetical case for analysis and decision, the issue then raised being surrounded largely by the possibility of the patient’s death as a, result of the operation.

If information is obtained by the doctor in such a circumstance, and he merely suspects that a criminal act has been performed, he does not become indictable if he does not

speak. But if be is furnished with absolute proof that there has been a breach of the law, and that a patient’s life has been sacrificed by it, his duty to. the cause of justice demands that he shall tell, since by remaining silent, he is assisting the criminal to avoid the penalty for the crime. In particular cases, however, a practitioner is, on the authority of the special committee of 1895, permitted to exercise his discretion where the life of the patient is in danger. As an Auckland medical practitioner put it: “If a man, covered with blood and badly injured, staggered into my surgery for attention, and in reply to my professional questions, tells me that he was the participant in a quarrel in which his opponent was killed, is it clearly my duty to report him as a murderer? The same applies to illegal operations, with the exception that here the patient consents to the operation. But she also takes the risk of dangerous complications.” MORAL DUTIES

The point of view of the “British Medical Journal” upon this question was expressed in 1903, when the Birmingham police circularised the profession for certain information—a practice which is operated today by the police in Auckland and elsewhere when a crime has been committed. The "Journal” said: “The information asked for by the police can only be given by violating the rule of professional secrecy, which enjoins all medical practitioners to keep silent upon matters which have come to their knowledge in the course of their professional duties. . . . We should refuse to become informers to the police.” Against that is the opinion of Dr. Dixon Mann, an eminent Home authority, who says: “A good citizen obeys the law, though he may have scruples in doing so; therefore, a witness should not set his private judgment against authority without very searching self-inquiry.. . . Privilege, then, is not so secure in the doctor’s hands as many patients believe, for in addition to possessing the duty of a medical man toward his patient, the doctor also owes a moral —and sometimes a legal—duty to the State. L.J.C.