Ethics and patient privacy
I was dismayed that in his article “Understanding the ‘joy’ of aggression” (Neuroscience News, Current Psychiatry, July 2004), Dr. Edmund Higgins discussed the pathology of the specific individuals shown in the photo that accompanied the article. Publicly attributing pathology to people (in this case, U.S. soldiers at Iraq’s Abu Ghraib prison) is inconsistent with our historical role as doctors who are sympathetic to our patients and respect their privacy.
As physicians, we encourage patients to share with us their problems, secure in knowing that they have our sympathy, that we advocate for them, and that we apply on their behalf our understanding and professional knowledge. These professional values are worth maintaining.
Whatever our feelings about atrocities committed by soldiers, individuals should be able to expect these values from medical doctors. The American Psychiatric Association’s Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry addresses this issue:
“Psychiatrists occasionally are asked for an opinion about an individual in the light of public attention, or who has disclosed information about himself or herself through the media. In such circumstances, a psychiatrist may share with the public his/her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he/she has conducted an examination and has been granted proper authorization for such a statement (1998 edition, section 7-3).”
Alan Lipschitz, MD
North Wales, PA
Dr. Higgins responds
Dr. Lipschitz raises an excellent point—one we must always keep in mind in these times of high media attention. His point does not apply to my article, however.
No individual was singled out nor were any names included. Likewise, no psychiatric diagnosis was made nor was any treatment suggested for any individual. The Abu Ghraib prison situation was raised simply as an example to speculate about brain activity during aggressive acts in general.