For at least three weeks, the Punjab police had been unofficially trying to tackle the state's notorious drug addiction problem by pressuring psychiatrists to reveal personal contact information of the drug addict patients coming to them for treatment. Now, the state government's Punjab Medical Council has made this controversial drive official: it has ordered all government doctors working in de-addiction programmes to submit data on all patients registered with them in the past three years, The Tribune reported.
The PMC has demanded this information by claiming that there are a large number of drug addicts getting further addicted to the de-addiction medicines prescribed to them by doctors. According to the Council, gathering personal information on patients would help them check the abuse of such habit-forming medicines by addicts who sign up at multiple de-addiction centres. The Council has also claimed that it is mandatory for doctors to reveal such information to the police in the larger interests of the community, under medical codes of ethics.
Outraged psychiatrists, however, claim that the PMC is actually going against medical ethics. For mental health professionals and doctors, disclosing any personal information of patients would be a blatant violation of the official code of ethics published by the Medical Council of India as well as a breach of the confidentiality agreement they have with patients. The code of ethics states that medical practitioners cannot disclose secrets of a patient that have been learnt in the exercise of their profession.
The real reason
Psychiatrists working in the field of de-addiction also allege that the PMC's reasons for demanding patient information are just excuses.
"It's a blatant excuse. Patients do not get further addicted to de-addiction medicines, which are a far less harmful substitute for dangerous addictive substances," said Dr Singh (name changed), a psychiatrist in Punjab who did not wish to reveal his identity. "Harm reduction is a well-accepted treatment strategy encouraged by the World Health Organisation."
Dr Singh and several other psychiatrists Scroll.in spoke to allege that the Punjab police had initiated the drive in various districts since the end of June, pressuring doctors to reveal contact details of their patients, with the aim of getting them to reveal the identities of drug peddlers.
“Through our psychiatrists’ network, I have been able to confirm that this is happening in at least four districts,” said a Chandigarh-based mental health practitioner on condition of anonymity. Doctors in both private and state-run hospitals and de-addiction centres have been approached by the police, he said. “Some doctors have tried to explain that this method is unacceptable, some have resisted and tried to buy time. But if this continues it could lead to a lot of harassment and arm-twisting of doctors.”
Pressure and intimidation
“I have had police officials enter my clinic and demand information about my patients in an intimidating manner – and this has also happened to several other psychiatrists I know,” said Dr Singh. “So far they have not entered my room in the presence of a patient, but imagine a police officer waiting outside your door for three hours, pressuring you to give out confidential information that would breach the unwritten contract between doctor and patient.”
Dr Singh said that many psychiatrists are willing to give the police the total number of drug addiction patients they have been treating, but not addresses and phone numbers of individual patients, which is what the police allegedly want.
“The police seem to think that we should give them this information because drug addicts are criminals,” he said. “My fear is that doctors in government hospitals might end up giving out information because they are in a more vulnerable position.”
Other medical professionals dismissed the idea that the police could justify their means just because drug abuse is a criminal offence. “Drug addiction is not just a ‘criminal’ act. There are many scenarios where ethics clash with superfluous legality,” said Dr Sanjay Nagral, a Mumbai-based surgeon and publisher of the Indian Journal of Medical Ethics. “It is the duty of the doctor to treat the patient and protect the patient’s privacy and confidentiality.”
Political back-story?
Some doctors believe the new police tactic was born out of the public spat between Chief Minister Parkash Singh Badal and union Social Empowerment Minister Thawar Chand Gehlot on June 26 in Hoshiarpur. Gehlot – a BJP leader – was in the district to inaugurate a new drug rehabilitation centre on the occasion of International Anti-drug Day.
During his speech, Gehlot claimed that Punjab had the highest number of drug addicts in India, which was seen as a jibe against Badal’s Shiromani Akali Dal. Badal countered Gehlot’s claims in his own speech by claiming that the state’s drug addiction problem was under control and that attempts were being made to tarnish Punjab’s image.
“That incident was all over the news and it was embarrassing for the chief minister – so this is most likely the reason why the government has asked the police to crack down on drug use urgently,” said the Chandigarh-based doctor. “I can’t think of any other reason why the police is trying to get information from psychiatrists, who have ready data on addicts.”
‘This could push people to suicide’
The method, however, is questionable for various reasons, say mental health professionals.
“For one, breaching confidentiality would violate our code of ethics. If the patient files a court case, he would almost definitely win,” said Dr Singh. Doctors could also get in trouble with the Medical Council of India and lose their licenses as practitioners.
“But the basic point is that this is intrusive,” said Singh. “Many patients don’t tell their families that they are seeing a psychiatrist. They are weak and vulnerable, and if their parents or spouses or children find out because of the police, some might end up committing suicide.”
Doctors are also afraid that the police drive might scare addicts off treatment and seeking help at de-addiction centres, which would inevitably push them back into drug abuse.
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The PMC has demanded this information by claiming that there are a large number of drug addicts getting further addicted to the de-addiction medicines prescribed to them by doctors. According to the Council, gathering personal information on patients would help them check the abuse of such habit-forming medicines by addicts who sign up at multiple de-addiction centres. The Council has also claimed that it is mandatory for doctors to reveal such information to the police in the larger interests of the community, under medical codes of ethics.
Outraged psychiatrists, however, claim that the PMC is actually going against medical ethics. For mental health professionals and doctors, disclosing any personal information of patients would be a blatant violation of the official code of ethics published by the Medical Council of India as well as a breach of the confidentiality agreement they have with patients. The code of ethics states that medical practitioners cannot disclose secrets of a patient that have been learnt in the exercise of their profession.
The real reason
Psychiatrists working in the field of de-addiction also allege that the PMC's reasons for demanding patient information are just excuses.
"It's a blatant excuse. Patients do not get further addicted to de-addiction medicines, which are a far less harmful substitute for dangerous addictive substances," said Dr Singh (name changed), a psychiatrist in Punjab who did not wish to reveal his identity. "Harm reduction is a well-accepted treatment strategy encouraged by the World Health Organisation."
Dr Singh and several other psychiatrists Scroll.in spoke to allege that the Punjab police had initiated the drive in various districts since the end of June, pressuring doctors to reveal contact details of their patients, with the aim of getting them to reveal the identities of drug peddlers.
“Through our psychiatrists’ network, I have been able to confirm that this is happening in at least four districts,” said a Chandigarh-based mental health practitioner on condition of anonymity. Doctors in both private and state-run hospitals and de-addiction centres have been approached by the police, he said. “Some doctors have tried to explain that this method is unacceptable, some have resisted and tried to buy time. But if this continues it could lead to a lot of harassment and arm-twisting of doctors.”
Pressure and intimidation
“I have had police officials enter my clinic and demand information about my patients in an intimidating manner – and this has also happened to several other psychiatrists I know,” said Dr Singh. “So far they have not entered my room in the presence of a patient, but imagine a police officer waiting outside your door for three hours, pressuring you to give out confidential information that would breach the unwritten contract between doctor and patient.”
Dr Singh said that many psychiatrists are willing to give the police the total number of drug addiction patients they have been treating, but not addresses and phone numbers of individual patients, which is what the police allegedly want.
“The police seem to think that we should give them this information because drug addicts are criminals,” he said. “My fear is that doctors in government hospitals might end up giving out information because they are in a more vulnerable position.”
Other medical professionals dismissed the idea that the police could justify their means just because drug abuse is a criminal offence. “Drug addiction is not just a ‘criminal’ act. There are many scenarios where ethics clash with superfluous legality,” said Dr Sanjay Nagral, a Mumbai-based surgeon and publisher of the Indian Journal of Medical Ethics. “It is the duty of the doctor to treat the patient and protect the patient’s privacy and confidentiality.”
Political back-story?
Some doctors believe the new police tactic was born out of the public spat between Chief Minister Parkash Singh Badal and union Social Empowerment Minister Thawar Chand Gehlot on June 26 in Hoshiarpur. Gehlot – a BJP leader – was in the district to inaugurate a new drug rehabilitation centre on the occasion of International Anti-drug Day.
During his speech, Gehlot claimed that Punjab had the highest number of drug addicts in India, which was seen as a jibe against Badal’s Shiromani Akali Dal. Badal countered Gehlot’s claims in his own speech by claiming that the state’s drug addiction problem was under control and that attempts were being made to tarnish Punjab’s image.
“That incident was all over the news and it was embarrassing for the chief minister – so this is most likely the reason why the government has asked the police to crack down on drug use urgently,” said the Chandigarh-based doctor. “I can’t think of any other reason why the police is trying to get information from psychiatrists, who have ready data on addicts.”
‘This could push people to suicide’
The method, however, is questionable for various reasons, say mental health professionals.
“For one, breaching confidentiality would violate our code of ethics. If the patient files a court case, he would almost definitely win,” said Dr Singh. Doctors could also get in trouble with the Medical Council of India and lose their licenses as practitioners.
“But the basic point is that this is intrusive,” said Singh. “Many patients don’t tell their families that they are seeing a psychiatrist. They are weak and vulnerable, and if their parents or spouses or children find out because of the police, some might end up committing suicide.”
Doctors are also afraid that the police drive might scare addicts off treatment and seeking help at de-addiction centres, which would inevitably push them back into drug abuse.