Medical Confidentiality Quotes

General Taylor participated in the celebration of the Fourth of July, a very hot day, by hearing a long speech from the Hon. Henry S. Foote, at the base of the Washington Monument. Returning from the celebration much heated and fatigued, he partook too freely of his favorite iced milk with cherries, and during that night was seized with a severe colic, which by morning had quite prostrated him. It was said that he sent for his son-in-law, Surgeon Wood, United States Army, stationed in Baltimore, and declined medical assistance from anybody else. Mr. Ewing visited him several times, and was manifestly uneasy and anxious, as was also his son-in-law, Major Bliss, then of the army, and his confidential secretary. He rapidly grew worse, and died in about four days.

The appropriation of terms from psychology to discredit political opponents is part of the modern therapeutic culture that the sociologist Christopher Lasch criticized. Along with the concept of the authoritarian personality, the term “-phobe” for political opponents has been added to the arsenal of obloquy deployed by technocratic neoliberals against those who disagree with them. The coinage of the term “homophobia” by the psychologist George Weinberg in the 1970s has been followed by a proliferation of pseudoclinical terms in which those who hold viewpoints at variance with the left-libertarian social consensus of the transatlantic ruling class are understood to suffer from “phobias” of various kinds similar to the psychological disorders of agoraphobia (fear of open spaces), ornithophobia (fear of birds), and pentheraphobia (fear of one’s mother-in-law). The most famous use of this rhetorical strategy can be found in then-candidate Hillary Clinton’s leaked confidential remarks to an audience of donors at a fund-raiser in New York in 2016: “You know, to just be grossly generalistic, you could put half of Trump’s supporters into what I call the basket of deplorables. Right? They’re racist, sexist, homophobic, xenophobic, Islamophobic—you name it.” A disturbed young man who is driven by internal compulsions to harass and assault gay men is obviously different from a learned Orthodox Jewish rabbi who is kind to lesbians and gay men as individuals but opposes homosexuality, along with adultery, premarital sex, and masturbation, on theological grounds—but both are "homophobes.” A racist who opposes large-scale immigration because of its threat to the supposed ethnic purity of the national majority is obviously different from a non-racist trade unionist who thinks that immigrant numbers should be reduced to create tighter labor markets to the benefit of workers—but both are “xenophobes.” A Christian fundamentalist who believes that Muslims are infidels who will go to hell is obviously different from an atheist who believes that all religion is false—but both are “Islamophobes.” This blurring of important distinctions is not an accident. The purpose of describing political adversaries as “-phobes” is to medicalize politics and treat differing viewpoints as evidence of mental and emotional disorders. In the latter years of the Soviet Union, political dissidents were often diagnosed with “sluggish schizophrenia” and then confined to psychiatric hospitals and drugged. According to the regime, anyone who criticized communism literally had to be insane. If those in today’s West who oppose the dominant consensus of technocratic neoliberalism are in fact emotionally and mentally disturbed, to the point that their maladjustment makes it unsafe to allow them to vote, then to be consistent, neoliberals should support the involuntary confinement, hospitalization, and medication of Trump voters and Brexit voters and other populist voters for their own good, as well as the good of society.

As it turned out, Mary Jo White and other attorneys for the Sacklers and Purdue had been quietly negotiating with the Trump administration for months. Inside the DOJ, the line prosecutors who had assembled both the civil and the criminal cases started to experience tremendous pressure from the political leadership to wrap up their investigations of Purdue and the Sacklers prior to the 2020 presidential election in November. A decision had been made at high levels of the Trump administration that this matter would be resolved quickly and with a soft touch. Some of the career attorneys at Justice were deeply unhappy with this move, so much so that they wrote confidential memos registering their objections, to preserve a record of what they believed to be a miscarriage of justice. One morning two weeks before the election, Jeffrey Rosen, the deputy attorney general for the Trump administration, convened a press conference in which he announced a “global resolution” of the federal investigations into Purdue and the Sacklers. The company was pleading guilty to conspiracy to defraud the United States and to violate the Food, Drug, and Cosmetic Act, as well as to two counts of conspiracy to violate the federal Anti-kickback Statute, Rosen announced. No executives would face individual charges. In fact, no individual executives were mentioned at all: it was as if the corporation had acted autonomously, like a driverless car. (In depositions related to Purdue’s bankruptcy which were held after the DOJ settlement, two former CEOs, John Stewart and Mark Timney, both declined to answer questions, invoking their Fifth Amendment right not to incriminate themselves.) Rosen touted the total value of the federal penalties against Purdue as “more than $8 billion.” And, in keeping with what had by now become a standard pattern, the press obligingly repeated that number in the headlines. Of course, anyone who was paying attention knew that the total value of Purdue’s cash and assets was only around $1 billion, and nobody was suggesting that the Sacklers would be on the hook to pay Purdue’s fines. So the $8 billion figure was misleading, much as the $10–$12 billion estimate of the value of the Sacklers’ settlement proposal had been misleading—an artificial number without any real practical meaning, designed chiefly to be reproduced in headlines. As for the Sacklers, Rosen announced that they had agreed to pay $225 million to resolve a separate civil charge that they had violated the False Claims Act. According to the investigation, Richard, David, Jonathan, Kathe, and Mortimer had “knowingly caused the submission of false and fraudulent claims to federal health care benefit programs” for opioids that “were prescribed for uses that were unsafe, ineffective, and medically unnecessary.” But there would be no criminal charges. In fact, according to a deposition of David Sackler, the Department of Justice concluded its investigation without so much as interviewing any member of the family. The authorities were so deferential toward the Sacklers that nobody had even bothered to question them.

unique to three areas: medical, pharmaceutical and basic research. Medical ethics covers informed consent, doctor-patient confidentiality, and organ donation, to name a few. “Outsourcing Medical Studies—and Ethical Quandaries—to Africa” by David Biello delves into the lack of medical ethics boards in Africa and how this affects participant safety

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He wrote one of the oldest medical ethics ever recorded, The Hippocratic Oath. The most famous rule in this oath is medical confidentiality.

her, he said, “Dr. Whitney, again thank you for joining us. Please know this meeting is informal but confidential. Its real reason—we need your help.” Surprised, she blurted, “Commissioner Jarvis, that I didn’t expect.” All three men laughed, and Keith said, “After all you’ve been through, we understand. Now, please relax. We’re all on a first-name basis here. May we call you Sue?” “Considering you know how I take my coffee, I suspect we’re beyond a first-name relationship.” Henry smiled. “Very good, Sue. You understand FBI tactics. We never ask a question without knowing its answer. But let me second Keith’s welcome. The FBI is anxious to acquire your help.” Unseen beneath the table’s edge, she wiped the moisture from her palms onto her pantsuit and said, “I’m pleased to help, if I can. But I need more details.” Keith said, “Indeed, and that’s what we plan to discuss. If you agree, our attorney, Bob Parker, is here to answer any legal concerns you might have.” “OK, I’m ready.” “The health department’s focus is on high-quality medical care, but a few bad apples outsmart us, work around us, employ new technology that confuses us, or simply submit fraudulent claims for payment.” Sue said, “I’ve seen my former colleagues do the same thing. I blamed it all on medicine becoming a business rather than a profession.

If doctors as a whole aren’t bound by a duty of confidentiality, patients generally will be less forthcoming, and the general confidence that the public reposes in the medical profession will be reduced.

Should the parents know what’s going on? In England the court has said that it should be assumed that parental involvement will be helpful (which means that it is in the girl’s best interests) (R (Axon) v Secretary of State for Health (2006)), but that this assumption can be displaced. The American Medical Association has given more or less identical advice: see Opinion 5.055: Confidential Care for Minors: 1996. It’s easy to understand why the assumption of disclosure is readily displaced: girls would often be discouraged from seeking medical help if they thought that their parents would be told.

A consequentialist account certainly gives reasons for why the doctor should not breach confidentiality on the grounds of the possible deleterious effect on the family. This is the main reason why most geneticists would not tell John that he is not the biological father of Sarah’s child. But it is not entirely clear that the consequences of keeping John ignorant are better than informing him of the truth. Is it right that Sarah needs to be protected from the consequences of her act and will it be better for the family if this remains a secret?

The only limitations are ones you impose on yourself.