Business Law and Ethics : Physicians and Professional SecrecyEssay title: Business Law and Ethics : Physicians and Professional SecrecyIntroductionOur law enforcement officials have a duty to protect citizens as well as discourage crimes from taking place. Our health care officials also have a duty to provide the best care possible to those who need it. Often enough, there have been many cases where both parties have come in contrast with each other on different levels of professionalism. The ultimate debate arises when doctors and law enforcement take into account the respect and privacy of patients. One of the issues that will be discussed in the paper focuses on the importance of doctors having to report gunshot wounds to the police. Many issues of ethics and morality come into play when judging which party is in favor. In our opinion, we believe that physicians should report patients that come in with gunshot wounds for reasons of discouraging criminal acts, protecting our society, and preventing future violence from taking place. This paper will explore the many moral, ethical and legal responsibilities of a physician, and analyze why it is important for them to report gunshot wounds to the police. Contrary to the Code of Ethics of Physicians and the Medical Act, we believe there is a pressing issue for public concern that is being strongly overlooked in this matter. We will explore the areas of human rights, professional secrecy, civil responsibilities, as well as patient consent in order to justify our claim.
The LawArticle 9 of The Charter of Human Rights and Freedom states that, “No person bound to professional secrecy should disclose confidential information and that the tribunal will ensure professional secrecy is respected.” We strongly believe this statement should not apply to gunshot wounds because it depicts that the law would only be protecting one person over society as a whole. A gunshot wound should not be bound by professional secrecy since; even professionals can determine a gunshot wound and it is not revealing a patient’s confidential information other than his condition. When a gun has been discharged the government has an obligation to protect society. In essence, the most important issues to consider in disclosure of confidential information are that the police have a specific role as well in protecting the well being of society. The police are responsible for assessing the risk posed by members of the public who are armed. Therefore, they have a need to consider the risk of further harm to those in the surrounding area. With the upscale growth of firearm violence throughout the country, police say hospitals have become safe havens for people who break the law, but some doctors say patient confidentiality trumps the need to report gunshot wounds.
Most physicians recognize the narrow public health and safety obligations to report a patient’s communicable diseases, gunshot wounds, signs of child abuse, or serious violent intentions–socially motivated exceptions to traditional pledges of confidentiality.
As these social issues immerge, we believe it is best for society to inform the authorities of any crime. Many argue that a patient with a gunshot wound may himself have been part of gunfire and would therefore be discouraged from obtaining medical help if physicians were to report the wound. However, shouldn’t a law protect society over one individual? When a patient is brought to the hospital for a gunshot wound it is crucial to take into account that the criminal is perhaps still at large and may harm someone else; that is, if the law enforcement is not informed. Forty-five American states have some form of law providing for mandatory reporting of gunshot or other wounds.
The Code of Medical Ethics states that the information disclosed to a physician during the course of the patient-physician relationship is confidential to the utmost degree, however they have permitted disclosures.
Furthermore, article 20.1 of the Professional Code of Physicians, argues, “A physician, in order to maintain professional secrecy, must keep confidential the information obtained in the practice of his profession.” Again, we understand the importance of non disclosure of important information relevant to any patients privacy, however when their condition becomes a matter of public order it is important that those in the public should be protected against any harm that might be caused otherwise. In the case of a gunshot wound, the person being reported may or may not pose a risk to the public. There is no clear intervention that can be undertaken to mitigate or eliminate this undefined, and probably indefinable, risk. In other words, it would only be fair to disclose any of the confidential information when the need for maintenance of confidentiality is outweighed by a reasonable concern for public safety.
The authors of the opinion also point out the important need for the public to know what is happening in hospitals:
“We know that, in some hospital settings, we see patients with gunshot wounds being treated, treated, transported to a hospital or examined for injuries. †Moreover, it has been reported that there is a growing number of patients who have been transported to such facilities to provide assistance when they need it.
“While it’s true that a large percentage of gunshot victim fatalities occur in hospitals, we know that many patients with gunshot wounds end up suffering a tragic and tragic outcome after being taken to a hospital. Â Many are being treated at the facilities which may be more accessible or more accessible to emergency departments.”
The authors, however, note that even in those private settings, there is widespread support for using the services of other, less-expensive practitioners to help patients cope with their trauma.
“We call on our physicians not to rely on private providers. Â Instead, we should not rely solely on private practitioners. Â This policy may allow us to create better communication and less litigation regarding care. We strongly believe that the use of professionals from the private sector to improve care for wounded patients is more important than the use by physicians for other purposes.”
[Footnote 1] It is unclear where of the four opinion points was derived that, for example, the first was specifically made during the final days of the trial, such as “a lack thereof was demonstrated to be a contributing factor to the death rate”. The trial court’s order is described in a footnote, and also in the paper by the same authors.
[Footnote 2] Since then, the law for allowing private practitioners to provide surgical services with a professional reputation and access to confidential information has evolved with the changing public needs. The case law and clinical practice practice guidelines have changed over time, including in both the private sector and the public.
[Footnote 3] This has resulted in an evolving set of “standardised and customary practice practices” of physician practice in practice for those trained to serve all needs but those experienced through non-hospital health care.
[Footnote 4] The American Medical Association has been the lead proponent of these “standardised” practices. A similar “standardised” practice of treating patients at emergency medical facilities has been widely adopted in New Glasgow, New Kent and South Wales.
[Footnote 5] New York (1995), where the first evidence-based consensus was found for the use of a private non-hospital physician in the surgical treatment of gunshot wounds and at the trauma to the pelvis (Hirschman, 1991; Miller et al., 1995), has endorsed and adopted the practice of using a physician to assist emergency staff in emergency surgical services.
[Footnote 6] New York City has followed the lead of other US cities such as New York and Los Angeles with their recommendations in support of the practice of requiring that private practitioners be trained in “providing professional care to the sick and homebound population”. The practice has been associated with increased hospital admissions and mortality among victims of gunings and shootings throughout the United States.
[Footnote 7] In the last few years, the use of private practitioners to provide surgical services has begun to change, as more patients are receiving medical assistance as well as a healthier community is able to afford such services.
[Footnote 8] The American Academy of Pediatrics (1993).
[Footnote 9] The case of Dr. James Risen in 2008, also on the basis of the medical evidence, was used as an intervention by the trial court in its decision that New