Wednesday, February 06, 2013

On Publishing the Psychiatric Records of Those Who Can't Say No


This past Sunday (Super Bowl Sunday, in fact), the lead article in the New York Times, front and center of the first page, above the fold and 4 pages long, was on the tragic story of a young man who died of suicide after the abruptly stopping prescription stimulants which he was reportedly addicted to.  Please read the article HERE.

The article goes into some detail about the young man's life, his talents, his charm, his zest for life and his hopes to become a doctor.  The reporter (and presumably his parents) state that his life took a sharp turn after he began using and abusing stimulants, and that it was all-too-easy for him to obtain high doses of medication with relatively little medical oversight and limited (or discouraged) input from his parents.  The story talks about his addiction, his violence, his stay in a psychiatric unit for a psychotic episode, his turn from success to failure, and finally his untimely and tragic death.  The parents obtained his psychiatric records after his death as per their legal rights, and excerpts from those records were published in the article.

I don't know what motivated the family to give psychiatric records to a New York Times reporter.  I am going to assume that in their grief, they wanted some good to come from the loss of their loved one, and one way to make this happen is to tell the tragic story, to warn others of the risks of prescription stimulants, to let people know that while amphetamines are sometimes safe, they aren't always, and awful things can happen.  I don't know if that was the motive, but it's the only one I come up with.  The article says the family does not plan to sue the doctors.

So I don't want to talk about Attention Deficit Disorder, and I don't want to talk about the details of the care this patient received.  Abuse of prescription medications and over-prescribing are clearly problems and prescription medications cause many deaths each year.  

What I want to know is what do you think about the idea of publishing someone's psychiatric records after they are dead?  It's clearly legal (I think) as they become the property of the next of kin who gave them to the newspaper.  But is that okay?  And I imagine the physician and the other prescribers did not give permission for their notes to be published in the paper, and I imagine that must be legal, too, to print the notes of a doctor (in context or out) as long as the patient or their proxy consents, but is that okay? 

 I've asked my family not to give my medical records to The New York Times after I die. And as a physician, I hope to never read my clinical notes in the newspaper.  What do you think?