by Craig Klugman, Ph.D.
Grey’s Anatomy (Season 13, Episode 9). A building collapses when a landlord has failed to make necessary repairs a year after an earthquake. The landlord mistakes a resident for a priest and confesses that his neglect was the cause of the tragedy that has led to much morbidity and mortality. The resident wonders if he has to preserve confidentiality like a priest or if information told to a doctor is different. A fellow resident tells him that since it’s not medically related, he has no obligation to maintain this particular confidence. Later, after surgerty the landlord tells the resident that he knows there was never a priest, but he simply needs someone to forgive him. The question then is whether the physician can offer a patient forgiveness for causing mass casualties to others. Of course, a physician must treat every patient the same irrespective of anything the patient may or may not have done in life. Thus the serial killer is treated the same as the cop. Health care professionals must make no moral judgments about choosing who to treat and how. But what if a patient admits criminal neglect? If the physician is a mental health professional, then the therapeutic privilege of confidentiality may protect the patient’s secret (unless there is an admission of fraud or abuse). But to your surgeon or anesthesiologist there is no such promise of confidentiality. In fact, the non-therapist physician may be obligated to report knowledge of the crime.
Chicago Med (Season 2, Episode 7-11/3) The main story line consists of a female patient who presents with altered mental status.