Respecting privacy and ethics

Client privacy is sacrosanct, and mental-health professionals especially need to understand the ethics of guarding it

Departed Bollywood actor Sushant Singh Rajput is a hot story these days, hogging the limelight for all the wrong reasons, with sensationalised reports on how his case is being handled.

However, a much broader and more serious issue here is about the dismal state of privacy when it comes to medical matters. The late actor’s therapist talking freely to the media and disclosing the nature of his mental illness raises serious questions about the privacy and medical ethics in our country.

In western societies, if medical professionals cannot keep patient details discreet or private, they are considered a disgrace to the whole profession. Such professionals are automatically ostracised and weeded out from the medical fraternity. Moreover, if such things occur, the patient and the patient’s family have full legal rights to sue the medical professional in question. That’s how seriously such breaches are taken by police and courts in many countries.

PRIVACY OUT OF THE DOOR

However, in our country, the concept of privacy in medical matters is quite alien.

One must remember that a medical professional can divulge certain details privately when questioned by responsible investigation agencies, although even that, is entirely at the discretion of the medical professional —Dr Aswin Sekhar

In India, it is quite common for a doctor in your family or friends’ circle to talk openly about your aunt’s piles, uncle’s impotency or friend’s terminal cancer without feeling any sense of guilt or shame. We, as a culture, have become so numb, insensitive and used to it. Most people in our country find nothing wrong with this and even think this is totally normal.

In reality, though, this is not normal practice in civilised societies/cultures. Every patient has the right to privacy and confidentiality when it comes to both physical and mental illnesses. The medical professional is responsible to respect this right and conduct himself/herself with discreteness and decorum. The same rule and restriction applies when the patient is dead as well. It is a matter of dignity and honour both alive and dead.

So also, the latest example of Sushant Singh Rajput’s psychiatrist disclosing the nature of his mental health issues to the media is a grave reminder of this problem in our country. It is pretty safe to assume that the actor would not have liked the whole world to know about the exact nature of his mental illness if he was alive.

LEGALLY BOUND TO PRIVACY

One must remember that a medical professional can divulge certain details privately when questioned by responsible investigation agencies, although even that, is entirely at the discretion of the medical professional. It is legitimate for the professional to keep all sensitive details of the patient as a secret forever. The medical professional is under no obligation to disclose a patient’s illness or medications or procedures. What’s more, no investigation agency (or police or intelligence official) has the rights to force secrets out of a medical professional unless it is a matter of exceptional importance concerning national security. There is enough protection from the law to guard medical professionals and patient’s privacy on this matter.

Of course, there’d be many wondering at the over-emphasis of privacy, secrecy and discretion here, thinking why it is a big deal if a friendly doctor talks about a relative’s high blood pressure or diabetes or cholesterol levels during a dinner party or wedding. True, it may not be the end of the world for some.

However, it is more of a matter of principle, values and medical ethics. Even a trivial medical problem need not be disclosed to a third party if the patient does not wish to disclose it himself/herself. It is akin to others sharing

your personal contact details with someone if you don’t want them to. BOUNDARIES OF SAFE SPACE Added to the above, when it comes to matters of couples’ counselling, sexual health and mental health therapy by psychologists and psychiatrists, things get really serious. It is no longer trivial anymore. One would expect strict confidentiality from such medical professionals because no one wants their private and sensitive content, which they divulged to their doctors and medical caretakers in a ‘safe space’ to be talked about in a crowd or splashed around all over the media. Careless disclosure of such sensitive aspects of people’s lives could throw them and their families into bigger risks of the patient advancing into more serious mental health problems. Such scars in itself are capable of driving a patient into depression (and sometimes even suicide). The cruel nature of our own culture’s taboos and stigmas accelerate these things beyond any logic or reason. Hence, professionals dealing with mental health matters have to be extra careful and mindful when having social conversations about their clientele with outsiders. It is certainly not worth it for these professionals to compromise their clients’ privacy for cheap publicity, financial gain or more attention.

It has been established that mental health problems can pose serious dangers to life just as physical health problems can too. This Bollywood suicide is not only a wake-up call for better showbiz work environments but also to the medical-media ethics and privacy standards of our own medical fraternity. If we aspire to be a civilised society, it is high time we do something about this.

It is certainly not worth it for professionals dealing with mental health matters to compromise their clients’ privacy for cheap publicity, financial gain or more attention on social media