SINGAPORE: A doctor who was fined S$50,000 for giving out a patient’s detail had his conviction overturned by the High Court on Friday (Oct 18) on the basis that the charge was not made out.
The decision was made following an appeal by the Singapore Medical Council (SMC) in May. SMC had filed the appeal after receiving new information in the case of Dr Soo Shuenn Chiang, who was fined in March by an independent disciplinary tribunal.
The psychiatrist had been fined for failing to verify the identity of a caller claiming to be the husband of one of his patients and for giving a memo containing confidential medical information about that patient to her brother.
The woman had been reviewed by Dr Soo for adjustment disorder, with depressed mood and alcohol misuse. She was also noted to have a risk of self-harm as she had a history of depression.
BROTHER UESD INFORMATION TO OBTAIN PERSONAL PROTECTION ORDER
In 2015, Dr Soo, the director of Neuroscience Clinic at the National University Hospital (NUH), passed a memo containing the patient’s medical information to his clinic staff to give to the patient's family.
The brother, who had posed as the patient’s husband during a call to the hospital, later collected that memo and used it to obtain a personal protection order against the patient.
The patient later filed a complaint with SMC, and Dr Soo pleaded guilty to one charge of professional misconduct.
Less than two weeks after the grounds of decision against Dr Soo were published, however, SMC found new evidence that raised doubt about the circumstances surrounding the incident.
The patient's brother had put his version of what happened on Facebook, saying that he had not impersonated the husband, who in fact had contacted Dr Soo.
SMC then approached both the patient’s brother and husband to record new statements.
It found that the brother’s and the husband’s account was different from that set out in the Agreed Statement of Facts, based on which Dr Soo had pleaded guilty.
With this new information, SMC applied to the High Court to overturn the conviction.
DOCTOR TOOK ‘REASONABLE’ STEPS
The court later decided to disregard the new information because they were not satisfied that the brother and husband's accounts were reliable.
However, having examined the record of proceedings, they questioned whether Dr Soo was even guilty of breaching the patient's confidentiality in the first place.
Upon considering the issues, the court decided that Dr Soo had taken reasonable, appropriate steps and had good reason in disclosing the patient’s confidential information.
“As a preliminary point, a doctor may disclose a patient’s confidential medical information without her consent when he reasonably regards it as necessary to protect the patient from potentially serious self-harm; disclosure is in the patient’s best interests; and the patient’s consent cannot reasonably be obtained," the court said.
"In such circumstances, the disclosure should be made to those closest to the patient, such as her next of kin,” it added.
In this case, upon receiving the call, Dr Soo had good reason to assess that there was a real risk the patient may commit suicide in the light of her past medical and psychiatric history, the court said.
The court also decided that Dr Soo could not possibly be held responsible for how the husband might choose to use or misuse the memo, if the memo had in fact been delivered to the husband as Dr Soo had instructed.
"That part of the charge which alleged that Dr Soo had failed to take appropriate steps to ensure that the complainant’s confidential medical information in the memorandum was not accessible to unauthorised persons was unacceptably broad," it said.
"Any administrative failings of the clinic staff in handing the memorandum to the brother contrary to Dr Soo’s instructions would fall outside the scope of Dr Soo’s duty to maintain the complainant’s medical confidentiality," it added.
As a result, the court held that the charge against Dr Soo was not made out and set aside Dr Soo’s conviction.
In its judgment, the court said that it was unsatisfactory that reliance had been placed on the "medical profession's propensity to protest loudly over the decisions of disciplinary tribunals".
Doctors have a responsibility to look after their own interests, it said.
"These factual elements should and likely would have been brought forth earlier had Dr Soo not been so keen to put this matter behind him, regardless of the cost to him and, it seems, to the medical profession," the court said in its judgment.
"Dr Soo could have contested the case on liability, and subsequently, even after pleading guilty to the charge, he could have appealed against at least the sentence imposed on him, but he chose to do neither," it said.
"It is not unreasonable in such circumstances to hold that he ought to lie on the bed that he has chosen to make for himself," it added.