Case Scenario I newly saw the na...

Case Scenario

I newly saw the name of united of my patients on a list of registered sex trespassers who reside in the same ZIP digest as our practice. This patient's name was listed beneath crimes against minors. Often, parents leave children unattended in our reception area despite our stationed policy that children younger than 12 years are to be accompanied on a responsible adult at all times.

I spoke to our risk management team, whose advice was, "Don't reveal anyone about him, just master him in and out quickly." Certainly, I don't want to be responsible for monitoring the comings and goings of everyone in the waiting extent when this patient is forward the schedule, and it does not present the appearance appropriate to divulge his status to our staff. However, I did mention one by one the staff that one of our patients is a convicted sex transgressor and to be mindful of unattended children in our office. At this time, however, I am the barely one aware of this patient's identity.

What are my ethical and legal obligations regarding this patient? What are my obligations regarding patients and staff with whom he might arrive in contact? Right now, I am in solo practice. If I hire an associate, should I disclose that physician the patient's identity? What should I say to staff if they descry his name on the registry and ask about him specifically?

Commentary

Before addressing the particulars of this scenario, it may be helpful to review the rife status of notification laws, which have evolv in the last decade. It is important to withhold in mind that the presumptive plan of community notification through registration is solely to inform the public, not to omit or deny sex offenders services, not to ostracize them, and not to undermine their readjustment into society.

In 1994 the U Congres passed the Jacob Wetterling Crimes Against Children and Sexually Violent transgressor Registration Act. The Wetterling Act required states to establish registries for convicted sex felons and to develop rigorous registration requirements for sex criminals who are considered dangerous (i.e., "sexually violent predators"). The Act required all sex convicts to report their addresses each year for 10 years, and required those classified as "sexually violent predators" to report their addresses each three months for the quietness of their lives. States that failed to comply with these provisions at September 1997 were subject to the forfeiture of 10 percent of the federal form grant funds earmarked for criminal justice intentions under the Edward Byrne Memorial State and Local Law Enforcement Assistance Program. by the agency of 1996, all 50 states had sex transgressor registries, and approximately 185,000 sex delinquents were registered under these state laws. (1) Congres amended the Wetterling Act in May 1996 The resulting law, known as "Megan's Law," mandated that the designated agency for each state "shall release relevant information that is necessary to screen the public concerning a specific individual required to register." (2)

Not surprisingly, the community notification laws have generated substantial litigation and a corpus of case law, more than 60 percent of which was published between 1997 and 1999 (3)

In answer to this particular physician's question the most constructive response is single in kind that is informed, low-key, and dispassionate and balances public safety with the basic civil rights of the sex offender

Although the information placed upon the registry is in the public domain, and therefore is not confidential, it does not mean that a patient's privacy rights can be abridged. Physicians are not obligated to inform their patients that another patient is listed forward the registry, and, of course, the physician cannot disclose the identity of the individual to other patients. Nevertheless, more [i]or[/i] less of the physician's patients may have seen registry notices, recognized this patient, and may inquire. Again, the physician cannot confirm or disown rumors about this or any patient. The physician may say something like, "If we become aware that a patient in our practice is forward the sex offender registry, please be assured that we will do everything we can to make sure the safety of our patients." The best that physicians can do is to demonstrate that they have taken "reasonable care."

The physician also may take a number of other grades Although the physician is not obligated to inform the office staff that this patient is upon the sexual offender registry, doing for a like reason in a low-key, nonalarmist tone may be appropriate and labor for several functions: (1) preparing the staff in case a patient approaches them with a question about this patient; (2) alerting the staff, if approached regarding this patient, to direct patients to the physician; and (3) allowing all staff to be vigilant for any signs of transaction The physician could explain to this patient that he is aware that the patient is in succession the registry, that the office is a potentially high-risk setting because children attend much [i]or[/i] regularly the waiting room, and that, inevitably, near of the other patients also may recognize him. The physician should assure this patient that the physician's office is a safe and comfortable place the pair for this patient and for the other patients.