Reporting crime

When can doctors report concerns about patients' criminal behaviour to the police?

Dr O'Hara's personal mobile phone is stolen from the drug addiction clinic where she works. She has good reason to believe that only six patients had the opportunity to steal the phone, when they attended the clinic for appointments. Nobody else entered her room during the time the phone went missing.

Dr O'Hara contacts her insurance company, who advise her to obtain a crime number from the police in order to claim for a replacement phone. She contacts the police and describes the circumstances in which the phone went missing. The police officer she speaks to asks for the patients' names, suggesting he needs them if he is to issue a crime number.

What should the doctor consider?

• The seriousness of the crime, and the impact on her of the theft.
• The implications for her patients' trust in her, and in doctors more generally, if she reports the crime.
• Whether there are steps she can take, other than contacting the police, that might address the issues raised by the theft.

What did the doctor do?

Dr O'Hara considers the implications of handing over the patients names to the police. She is aware of the importance of confidentiality to the trust between her and her patients and the fact that even the fact of an appointment could reveal information about her patients that might deter them and others from seeking medical attention in the future. This may be particularly important for patients seeking treatment for drug addiction, who may be especially sensitive to the police being informed (by inference) of their illness.

Dr O'Hara considers the various factors. On the one hand, disclosure solely of a patient's name is not as obvious or usually as serious a breach of confidence as the disclosure of a diagnosis or other detailed clinical information.

On the other hand, she knows that the fact of a patient's appointment should usually be treated as confidential: the six patients concerned and others might regard even such a limited disclosure as a very significant breach of trust.

After discussing the situation with a senior colleague, Dr O'Hara decides that, although the theft has upset her and cost her financially, disclosing information about her patients is unlikely to be justified, especially given the sensitive nature of their illnesses and as she is unsure which of the patients is responsible for the theft.

Dr O'Hara does, however, report the incident (without the patients' names) through the clinic's normal procedures and instigates a review within the clinic about how personal items should be kept and protected to prevent something similar happening in the future.

• What should you do in this case?
• What ethical principles from your readings apply?