The San Francisco call., 1905-06-04
DOCTOR MUST STAND
BY MEDICAL CODE
Cannot Reveal Any Secrets
RepoSed in Him by a
Patient.
Special Dispatch to The Can.

LONDON, June Sis a doctor justi-
fed in violating the code of medical
ethics in order to avert a possible
disaster that may cause a great loss
of human life?
That in a nutshell is the question
which perplexed member OF the. med
ical profession has submitted to the
British Medical Journal for solution
and has been answered in effect by
that high authority that his first duty
is to stick to the code. let the conse-
quences be what they may. AS the
case on which the moral cenupdrum
is based Is remarkable one and the
etiquette of the profession is about the
same on both sides of the Atlantic. 1t
is a matter that will possess some in
terest for American readers.
1t appears that certain doctor who
is engaged by railway provident So
ciety, managed by the men and not by
the company, was consulted by sig
mailman who was found to be suffering
from heart disease, that might cause
him to drop dead at any moment or
without warning render him incapable
OF attending to the work on whose per-
formance depended the safety of thou
sands of passengers. On this account
the doctor urged him to seek some
other employment where his liability
to sudden death or collapse would not
endanger other lives. The man re-
fused Other jobs were not easily
found. especially by Il man suffering
from heart disease. Self-preservation
was the first law of nature. Therefore
he would stick to his job and the trav-
cling public who need that particular
section of the line over which he stood
guard would have to take their
schances BY such reasoning he found
1t easy to justify his decision.
But the medical man was haunted
by the knowledge that his patients
condition might lead to an appalling
disaster in which scores OF lives might
be lost and hundreds be MANNED and
injured All possibility of such a ter
rible catastrophe would be averted il
he should inform the railway company
of the signalman's physical condition.
That would lead to his prompt removal
from the signal box. He might be Civ
en- another job. or he might be dis
charged. But IL the doctor should in
form the company of the facts that had
come to his knowledge in his profes-
sional capacity would he not be guilty
of a breach of the obligations imposed
upon him as a physician? In this di-
lemma he asked the British Medical
Journal to decide for him.
Our correspondent says the editor,
has done his duty by pointing out to
the patient his unfitness for work, but
he would be violating the rule of pro-
fessional secrecy if he communicated
to the company the facts which have
become known to him in his profess
sional capacity" Which amounts to
saying that considerations of medical
etiquette are of more Importance than
the security OF railway passengers.
with this opinion the public will hard
lv agree The rule that doctors should
not disclose what their patients tell
them is doubtless an excellent one in
the vast majority of cases. But this
seems to be a case in which incalcu-
lably greater harm may arise from
sticking to the rule than by making
an.exception to 1t. 1t would be inter.
esting to obtain the opinions OF Amer
lean physicians on the subject.