Doctors should report dangerous patients

Sean Hannity, Mark Levin, and other conservative talk show hosts are outraged by President Obama's Executive Order encouraging doctors to report potentially dangerous patients. I'll engage the conservative part of my brain, keep the liberal part in check, and scratch my head in befuddlement wondering why they'd object to what seems to me to be a common-sense directive. Even in my 100% dyed-in-the-wool conservative years in which I worked as an ER doctor in very violent areas, I never thought my political opinions should interfere with me doing the right thing: reporting potentially dangerous patients to the government, and involuntarily committing anyone who seemed to be a danger to themselves or others. As I discussed in another article, I often did that, and always with justification.

Judging by what Dr. Keith Ablow said on Fox News after the Newtown massacre (as I mentioned in that article), some other ER doctors and healthcare professionals let potentially dangerous patients walk away, which of course gives them the freedom to go postal. How is that helping the patient? I had a duty to protect patients every way possible, so if a patient said or did something to make me question whether it was safe to discharge him or her from the emergency department, the patient was never discharged. I'm sure I saved lives by being cautious.

Levin's concern is that patients might shun doctors to avoid being reported to the government. I understand his concern, but I don't think it is valid because such reporting has been going on for decades in my state and patients still openly disclose what's on their minds. Levin has a brilliant mind, but he isn't a physician as I am, nor has he seen myriad patients with various degrees of mental illness, as I have. The common denominator in all that psychopathology is that people nutty enough to consider violent acts feel their anger and desire for revenge is justified. To them, it seems so normal and so justifiable no one would object to it, so why not spill the beans?

I was absolutely shocked by how candid violent nuts were in telling me what was brewing in their twisted minds. Sometimes they'd blurt out incriminating info spontaneously, while other times they would say something odd enough to make me question them, and when I did, I always found corroborating evidence confirming my hunches.

Doctors do not have crystal balls, but we should have the judgment that enables us to detect who is a ticking time-bomb and who is just harmlessly blowing off steam. Thus, I think President Obama is simply encouraging healthcare professionals to do what they should have been doing all along. The psychiatrist (Dr. Lynne Fenton) who treated Colorado movie theater shooter James Holmes is being sued; the lawsuit alleges she “knew Holmes "was dangerous" and had a "duty to use reasonable care to protect the public at large" from him.

What is reported isn't always accurate so I won't second-guess what she and others did, but if Holmes were my patient, I strongly suspect the people he killed and injured would be alive and well.

Related topics

The Newtown massacre: We need nut control, not gun control

Why restricting gun magazine capacity is a bad idea

The views expressed on this page may or may not reflect my current opinions, nor do they necessarily represent my past ones. After reading a slice of what I wrote in my various websites and books, you may conclude that I am a liberal Democrat or a conservative Republican. Wrong; there is a better alternative. Just as the primary benefit from debate classes results when students present and defend opinions contrary to their own, I use a similar strategy as a creative writing tool to expand my brainpower—and yours. Mystified? Stay tuned for an explanation. PS: The wheels in your head are already turning a bit faster, aren't they?

“The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function.”
F. Scott Fitzgerald

Reference: Imagining dialogue can boost critical thinking: Excerpt: “Examining an issue as a debate or dialogue between two sides helps people apply deeper, more sophisticated reasoning …”

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