Medical Confidentiality in a criminal case

[ffutures]

For a story I'm writing set in the USA various agents have determined that Doctor A has been sending an extremely dangerous drug to various third parties with terminal illnesses, suggesting that it might help them. There is no reason to believe that this is true, but the drug has occasionally produced spectacular results. One of the recipients and

Comments

[raktajinos]

Im not a doctor, but I am an almost-licensed paralegal in Canada (and as such I'm not an expert on US law, but I engage with enough bi-national issues on a daily basis that I feel okay about it). Hopefully someone else will comment who may have a more direct experience with this issue.

Confidentiality only exists in relation to the patient's medical records. If B refuses to give the location of A to the police, he would be harbouring and preventing the process of justice (which he himself could be arrested/charged for). Since you're trying to avoid the arresting thing this may not work, but you could utilize the threat of arrest (and de-licensing) or you could use the anti-terrorism legislation that would allow the police to detain and interogate someone without the arrest element.

Additionally, B could be compelled to speak even within the confines of confidentiality. If the issue is dire enough (and in your case, of national public health) the highest levels of privileged confidentiality can be breached through a legal compelling to testify.

Also, B's professional ethics prevent him from serving as a "dupe and tool" to criminal behaviour and he has a professional obligation to report it or any involvement he has. You say B's not confident that there is illegal behaviour going on but that he isn't surprised. This could be your way.

I would look more closely at the Code of Ethics for Medical Professionals in the US for the specific exceptions on this though. Their regulation board website will have the document.

You could also go a more creative way and have one of the impacted characters sue B (and maybe A as well) for negligence and failure to meet a standard of care. This lawsuit could force B to release info about A in order to prove his own innocence. The government could also sue B for conspiracy - which would additionally force B to prove he is not a co-conspirator.

edited to add: you could also have the manufacturer of the drug join in on the lawsuit (if its a legal drug) and have them sue B and A for negligent distribution.

But realistically, I would argue that his not saying anything is going beyond the scope of confidentiality. The code won't allow you to maintain confidentiality in the support of a crime.

[disclaimer: this in no way constitutes legal advice and should you require legal advice, you should seek representation on your own accord. no client-agent relationship has been created in this hypothetical discussion of this topic for a work of fiction]

[ffutures]

Thanks - this is more or less what I was hoping might be the case. It helps a lot.