Dilemma 33: Breaking Bad (or Good) Dr. Jesse Pinkman has been working with a 26-year-old professional for about a year, Ms. Skyler White. They have been working on managing her symptoms of depression and anxiety. The patient smokes marijuana regularly, which has been a concern for Dr. Pinkman. Skyler arrives late to her appointment, looking frazzled. She explained her friend overdosed on heroin the prior evening. She has been in the ER for the past 12 hours. Her friend will likely survive, but she may have residual cognitive problems. Skyler reported feeling horribly guilty because she introduced her friend to her next door neighbor, who is the drug dealer. Her friend always stops by to see Skyler first, before purchasing drugs. Skyler purchases her marijuana from the same dealer. After processing the events of the previous evening, Skyler stated she will move away from the drug dealer. She no longer wants to be this close or indirectly cause harm to someone else. The police are actively investigating, but Skyler does not want to divulge any information. She does not want to get involved. Skyler makes an appointment for next week, and then leaves feeling somewhat better. Dr. Pinkman becomes preoccupied about what Skyler reported. Dr. Pinkman knows the dealer's name from previous sessions and can figure out the address of dealer, based on his patient's address. Dr. Pinkman is contemplating calling in an anonymous tip to the police. Dr. Pinkman is aware of the increase in heroin use in his community. He also recognizes his struggle with moral outrage and sense of injustice in this situation. Struggling with the emotions to report or not report anonymously, Dr. Pinkman calls you for a consultation. What are the competing ethical principles in this situation? How would you feel if you were Dr. Pinkman? What are some of the positive and negative consequences about Dr. Pinkman making the anonymous report? How do your own professional values and personal morals influence how you would respond to Dr. Pinkman? How would you respond to Dr. Pinkman's moral outrage? Would your answers differ if the friend died? Would your answers differ if the patient was of low socio-economic status? Would your answers differ if Skyler were a teenager?