OH v. Richardson Patient Confidentiality Explained

September 11, 2019

BY SEEMA IYER | COURT TV

When Brooke Skylar Richardson, a former high school cheerleader, went on trial for allegedly killing her newborn baby, who imagined pom-poms would feature less prominently than the doctor-patient privilege? Doctor after doctor, along with some supporting medical staff, has paraded into a Cincinnati-area courtroom to apparently dismantle what we know as doctor-patient confidentiality.

 

 

The saga began when Richardson went to her doctor, Dr. William Andrew, on April 26, 2017. Dr. Andrew has literally known Richardson since she was born – he was the physician who delivered her. The purpose of the appointment was talking birth control options. Instead, Dr. Andrew informed Richardson she was in the late stages of pregnancy.

The doctor advised Richardson to tell her parents about the pregnancy, to make an appointment for an extensive ultrasound, and to return for pre-natal care. Richardson did none of the above. Staff at the doctors’ office, Hilltop OB-GYN, and Dr. Andrew himself repeatedly called Richardson and received no response. Richardson gave birth to a baby girl, she claims was stillborn, on May 7, 2017, then promptly buried the baby in the backyard. Richardson went back to Hilltop OB-GYN on July 12, 2017, for a birth control refill; this time she saw Dr. Casey Boyce. A staff member noticed Richardsonwas returning without a baby and thus informed Dr. Boyce. Richardson told Dr. Boyce that she delivered a stillborn and buried her in the backyard. Dr. Boyce consulted with Dr. Andrew before the two doctors decided to contact law enforcement. On August 4, 2017, Richardson was indicted on aggravated murder and related charges.

Wait – what happened to doctor-patient confidentiality? Sorry, that doesn’t apply here.

Confidentiality is dictated by laws of privacy. An extension of that is physician-patient privilege, which protects communications between a patient and their doctor from being used against the patient in court. So, the minute the doctors got the cops involved, we leave the realm of confidentiality and head to the province of privilege. It’s important to recognize that the duty of confidentiality is not absolute. States put limitations on privilege so a doctor can disclose information that indicates a crime has occurred or may occur. Most states mandate physicians to alert law enforcement of any violence-related crimes. And The American Medical Association’s Code of Medical Ethics dictate the exception to confidentiality must be followed – “[a] physician shall safeguard patient confidences and privacy within the constraints of the law.”

In Ohio, where Richardson is being prosecuted, the law codifies the doctor-patient privilege, yet also recognizes that a person with a special relationship to a minor, must report abuse or neglect. This type of statute is known as mandatory reporting. Doctor-patient confidentiality is a legal duty. However, it is not absolute. Exceptions to the privilege include:

1) the patient waives the privilege; or
2) the doctor has information that a crime has occurred or is about to occur; or
3) some other emergency situation.

In the case against Richardson, the mandatory reporting requirement for doctors fell within an exception to the doctor-patient privilege – most notable where a doctor has reasonable cause to suspect a child has suffered any physical injury. And that’s why the doctors have testified for the prosecution.

Bottom line, when doctors take the Hippocratic Oath and say, “I will never divulge, holding such things to be holy secrets” – well doc, never say never.

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