REPLY
The Prison Patient
Matthew D.S. Klein, MD
15 June 1998 | Volume 128 Issue 12 Part 1 | Page 1050
IN RESPONSE:
Dr. Bellin proposes interesting solutions to the ethical dilemma encountered by Bennett, the prison physician. The young Bennett believes that his patient's well-being is his prime responsibility. In the prison, he encounters a challenge to that ethic for the first time-that his patient's health may infringe on societal tranquility.
At Rikers Island, Bennett would have been forbidden to learn Masterson's criminal record. But to mandate physicians' ignorance of their patients' criminal records is to simplify ethical dilemmas by ignoring them. Bennett was in a position to alter a recidivistic pedophile's behavior. He was forced to question his patient's primacy in the face of societal risk. Society often expects us to balance its interests with those of our patients-as when we deny driving privileges to epileptic patients. The primacy of the individual patient is sometimes challenged in more subtle ways, too-when families tell us secrets about Grandpa's alcohol use, or the truth about Mom's dementia. It is not a solution to ignore these outside data. It is not good medicine to address our attention only to the benefit of the individual.
Bennett transgressed by acting as solitary "judge and jury," and it is true that he used deceit to accomplish his ends. But at Rikers Island, the story would have ended with a priapic Masterson, soon to be released. Is that really a happy ending?
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