Scott: The Hippocratic oath demands, specifically, that doctors "never divulge" information about patients. Hence the psychiatrist who released tapes of a poet's therapy sessions after the poet's death violated his oath by his actions, even though the tapes were released after the poet's death and to the poet's official biographer. It makes no difference that the poet's published works were written in a confessional manner or that she had assured the psychiatrist that he could do with the tapes as he saw fit.
Bonara: I agree that doctors are bound not to divulge patient information and would not myself release such tapes without written permission from the patient. Nevertheless, I disagree that the circumstances were irrelevant in this case. I do not think the poet's psychiatrist violated the Hippocratic oath.
Which one of the following principles, if established, helps most to justify Scott's evaluation of the psychiatrist's actions?Scott’s view is that the psychiatrist violated the oath by releasing the tapes, regardless of the poet’s death, public writing style, official biographer, or informal permission.
The principle needed must support the idea that patient confidentiality cannot be waived by the patient’s permission in this situation.
(A) Restrictions on the release of patient information by psychiatrists are not binding after the patient's death, since after death a person can no longer suffer harm.
This weakens Scott’s view. Scott says the release was wrong even though it happened after the poet’s death.
(B) Once a patient has granted a psychiatrist permission to release confidential information, that information can be released to anyone at the psychiatrist's discretion.
This also weakens Scott’s view. Scott says the poet’s permission did not matter.
(C) Since a psychiatrist could influence a patient's opinions during therapy, any directives to the psychiatrist by the patient must be interpreted in the light of the patient's actions outside the therapeutic setting.
This does not justify Scott’s evaluation. It suggests that the poet’s outside actions may matter, but Scott says the circumstances were irrelevant.
(D) Since any psychiatrist's divulging to the public information about a patient could undermine the trust of other patients in their psychiatrists, no patient can release a psychiatrist from the obligation to keep patient information confidential.
This is correct. It directly supports Scott’s claim that even if the poet gave permission, the psychiatrist still had a duty not to divulge the information. The obligation exists because of
the broader need for trust in psychiatry, not merely because of the individual patient’s wishes.
(E) If a patient has expressed an intention to make public information about himself or herself that is in a psychiatrist's possession, the psychiatrist is released from the obligation to keep that information confidential.
This weakens Scott’s view. Scott says the poet’s confessional writing and permission did not release the psychiatrist from the duty of confidentiality.
Answer: (D)