Hypothetical Ethical Dilemma: what would you do?

[coreytayloris]

You're a plastic surgeon. You operate on celebrities and non celebs alike.

One day a man comes to you looking to have surgery on his penis to remove a birthmark.

You do the operation and all is well.

A few months later you are watching the news and the same man appears on screen outside a courthouse giving a speech.

It turns out he has been cleared of 8 counts of paedophilia, the main evidence in his favour was that all eight boys he molested claimed he had a specific birthmark on his penis, and when physically examined no such mark existed.

What do you do? Of course he gave you a fake name. By breaking confidentiality agreement with the patient to report to the police you will also be compromising your practice, high profile clients won't come to you if they think you will spill the beans. other patients just won't trust you etc. what do you do?!!

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[Bacchus]

You should probably go jump off a high bridge if you do nothing.

As a provider in the US, reporting of sexual assault is mandatory. This is an admittance, of sorts, and you would be legally obligated to report.

 

[phenylacetone]

You're a plastic surgeon. You operate on celebrities and non celebs alike.

One day a man comes to you looking to have surgery on his penis to remove a birthmark.

You do the operation and all is well.

A few months later you are watching the news and the same man appears on screen outside a courthouse giving a speech.

It turns out he has been cleared of 8 counts of paedophilia, the main evidence in his favour was that all eight boys he molested claimed he had a specific birthmark on his penis, and when physically examined no such mark existed.

What do you do? Of course he gave you a fake name. By breaking confidentiality agreement with the patient to report to the police you will also be compromising your practice, high profile clients won't come to you if they think you will spill the beans. other patients just won't trust you etc. what do you do?!!

Did you guys finally get the first season of Nip/Tuck over there in Ireland?

 

[Dral]

Yeah, report it, done. All confidentiality is down the tubes when something like that is involved.

The only way I see one's practice suffering, is that other pedophiles wouldn't come to you for care. Win win.

 

[officedepot]

.

 

[kitanai]

In this case we have to ask the question, what are the grounds that a patient-doctor relationship should be broken? If so,is relationship founded on fraud still a valid patient-doctor relationship?

I think personally, this is a case where you have to break the confidentiality because he is now a public threat. Remember, a patient-doctor relationship is meant to protect the patient from harm due to exposing his vulnerabilities. Yet, this is not the case. If we don't report it and he gets acquitted, then you are putting more kids in danger. I think the safety of the public should be our priority in here.

 

[Dral]

In this case we have to ask the question, what are the grounds that a patient-doctor relationship should be broken? If so,is relationship founded on fraud still a valid patient-doctor relationship?

I think personally, this is a case where you have to break the confidentiality because he is now a public threat. Remember, a patient-doctor relationship is meant to protect the patient from harm due to exposing his vulnerabilities. Yet, this is not the case. If we don't report it and he gets acquitted, then you are putting more kids in danger. I think the safety of the public should be our priority in here.

All very true and exactly correct. Moreso, thankfully these things are made to be relatively objective in the US. As a physician, if you don't report this sort of thing, you run the risk of losing your license. It's pretty black and white.

Kid in the ED with immersion burns...we report that shiznit, even if you think it might not be abuse. Tell the parents that we have to do it by law. We're not trying to make friends...we're trying to protect people who may not be able to protect themselves.

 

[coreytayloris]

Did you guys finally get the first season of Nip/Tuck over there in Ireland?

Haha, yeah, you got me
I heard we might be getting broadband here as well next year, this dial up stuff is a little too primitive!!!!!

 

[SexualOffender]

If you have reason to believe that the patient will harm someone, then you must report what you know. Otherwise, it's generally considered a violation of confidentiality. The point is to prevent future harm - you're not preventing future harm by turning in a guilty but now harmless man.

Ie, a schizophrenic admits that he killed someone twenty years ago, but now he sees a psychiatrist and is stable on meds - no need to report that. OTOH, a schizophrenic comes in and tells you he killed someone yesterday - obviously you need to report that since he has shown himself to be a danger to the people around him right now.

In this pedophile case, I guess it depends on the details. Did the abuse take place in the past few months? Then he'll probably be back to abusing kids some time soon. Did it happen thirty years ago before he retired from his job as a teacher? Then it's not so clear.