# When The Hippocratic Oath and Doctor/Patient Confidentiality Collide... **URL:** \ **Category:** Factual Questions\ **Created:** [January 2, 2013, 5:23am UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806 "2013-01-02T05:23:05Z")\ **Posts on this page:** 13\ **Page:** 1
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [January 2, 2013, 5:23am UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/1 "2013-01-02T05:23:05Z")
What happens? Let’s say a person admits to a psychiatrist that they have developed an addiction to a particular medication that is being prescribed by another doctor. Does this psychiatrist have an obligation to inform this other doctor of their mutual patient’s issues? Would not doing so, while having all the necessary information, be considered a breach of medical ethics? Or would not upholding a patient’s privacy be considered the bigger breach? ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [January 2, 2013, 5:58pm UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/2 "2013-01-02T17:58:26Z")
Bump. Nobody? Any doctors out there? ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 2, 2013, 6:08pm UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/3 "2013-01-02T18:08:00Z")
Physicians are generally required by state law to disclose drug seeking behaviors to other treating physicians. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [January 2, 2013, 6:19pm UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/4 "2013-01-02T18:19:21Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Physicians are generally required by state law to disclose drug seeking behaviors to other treating physicians. But it wouldn’t really be “drug-seeking behavior” if the person developed an addiction to a legitimately needed medication being prescribed by a physician for an actual medical condition. The addiction would be an unfortunate byproduct of long-term use of the medication. If the person sought out the counsel of a psychiatrist in order to divulge this information, with the (perhaps naïve) understanding that what is disclosed in session remains confidential, how could the psychiatrist disclose this info to a third party? Wouldn’t this be one hell of a disincentive for the person struggling with the problem to ever come forward in hopes of getting treatment? ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 2, 2013, 6:22pm UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/5 "2013-01-02T18:22:27Z")
Oh, I didn’t read your hypothetical properly. Unless the patient is trying to obtain more of the same medication from the psychiatrist, then no, he is unlikely to have an obligation to disclose the addiction. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [January 2, 2013, 6:27pm UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/6 "2013-01-02T18:27:29Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Oh, I didn’t read your hypothetical properly. Unless the patient is trying to obtain more of the same medication from the psychiatrist, then no, he is unlikely to have an obligation to disclose the addiction. So even though the psychiatrist is aware of the addiction to the medication and the doctor who is continuing to unwittingly prescribe the medication, they are under no obligation to inform the unwitting doctor of the true nature of their patient’s situation? ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [January 2, 2013, 11:02pm UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/7 "2013-01-02T23:02:58Z")
I am not a doctor or a lawyer but my understanding is that medical confidentiality applies to non-medical people. Different doctors treating the same patient are allowed and even supposed to keep each other informed about the health issues of their common patient. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [January 3, 2013, 2:19am UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/8 "2013-01-03T02:19:25Z")
> [@Little\_Nemo](#): > > I am not a doctor or a lawyer but my understanding is that medical confidentiality applies to non-medical people. Different doctors treating the same patient are allowed and even supposed to keep each other informed about the health issues of their common patient. So in the hypothetical I’ve described, the person with the addiction would have to be willing to admit their addiction to their prescribing doctor (or at least have it be known by that doctor) if they wanted to even discuss their problems with a psychiatrist. This was always my understanding as well but the ambiguity of such a particular situation made the answer somewhat murky to me. It just seems like a large disincentive for the patient to make that first step into the psychiatrist’s office. ---
**Author:** ![Fiveroptic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fiveroptic/32/8257_2.png) [@Fiveroptic](https://boards.straightdope.com/u/Fiveroptic)\ **Post date:** [January 3, 2013, 3:20am UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/9 "2013-01-03T03:20:22Z")
In Michigan the psychiatrist needs permission from the patient in the form of a signed release. The patient signs a release, valid for six months, specifying which doctors can be contacted. The patient can rescind authorization at any time. ---
**Author:** ![solosam](https://avatars.discourse-cdn.com/v4/letter/s/9d8465/32.png) [@solosam](https://boards.straightdope.com/u/solosam)\ **Post date:** [January 3, 2013, 3:42am UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/10 "2013-01-03T03:42:17Z")
I thought doctors were allowed to talk to other doctors. This sounds like it could be on Scrubs: “Hey Turk, I got a patient I need you to operate on.” “Sure thing, JD, what’s wrong?” “I can’t tell you. Patient confidentialty.” “Ummmm… But I’m the surgeon…” “Right, so I guess we’ll have to cover the patient’s face so you don’t know who you’re operating on, either. In fact, just wear a blindfold while you’re rootin’ around in there.” ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [January 3, 2013, 4:04am UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/11 "2013-01-03T04:04:56Z")
> [@solosam](#): > > I thought doctors were allowed to talk to other doctors. > > This sounds like it could be on Scrubs: > > “Hey Turk, I got a patient I need you to operate on.” > “Sure thing, JD, what’s wrong?” > “I can’t tell you. Patient confidentialty.” > “Ummmm… But I’m the surgeon…” > “Right, so I guess we’ll have to cover the patient’s face so you don’t know who you’re operating on, either. In fact, just wear a blindfold while you’re rootin’ around in there.” Except this isn’t like that at all. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [January 3, 2013, 4:10am UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/12 "2013-01-03T04:10:27Z")
> [@Fiveroptic](#): > > In Michigan the psychiatrist needs permission from the patient in the form of a signed release. The patient signs a release, valid for six months, specifying which doctors can be contacted. The patient can rescind authorization at any time. But there has to be a point at which that confidentiality can be broken and other doctors can be contacted irrespective of the patient’s authorization, no? What if the patient admitted to stealing from this doctor’s office? Or, when admitting to their addiction, the patient also admitted to suffering from life-threatening effects from that addiction? My question is where is that line? ---
**Author:** ![ryanl](https://avatars.discourse-cdn.com/v4/letter/r/b487fb/32.png) [@ryanl](https://boards.straightdope.com/u/ryanl)\ **Post date:** [January 3, 2013, 5:19am UTC](https://boards.straightdope.com/t/when-the-hippocratic-oath-and-doctor-patient-confidentiality-collide/645806/13 "2013-01-03T05:19:41Z")
Doctors prescribing narcotics may require a patient to sign a narcotics contract stating that the patient waives any privileges or confidentiality and authorizing the physician to cooperate with law enforcement in the investigation of possible illegal/inappropriate use of medication.