Author Topic: Dr. Kevin Patterson- The Article  (Read 48184 times)

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Offline Emenince Grise

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Dr. Kevin Patterson- The Article
« on: August 04, 2007, 09:46:55 »
A Canadian doctor and writer has written an account of his recent tour of the hospital in Kandahar. The publication of his story,

http://www.motherjones.com/news/feature/2007/07/talk_to_me_like_my_father.html

has caused some distress and consternation because it describes, in graphic detail, the accidental death of Cpl. Kevin Megeney and the steps Canadian doctors took when Megeney was brought into the ER. A military investigation has been initiated.

Certianly there are ethical issues involved here, but Cpl. Megeney's mother did read the article prior to publication, did not object to publication and asked that Cpl. Megeney's memorial web site be linked to the article on the Mother Jones web site.

Globe & Mail article here:

http://www.theglobeandmail.com/servlet/story/RTGAM.20070804.wafghan04/BNStory/National/home


Offline PMedMoe

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Re: Doctor's gory tale angers soldier's family
« Reply #1 on: August 04, 2007, 10:44:36 »
I have to say, it's well-written (yes, graphic, too) but I think he shouldn't have mentioned Cpl Megeney's name.  Not really sure what should be done about it, though.
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Offline George Wallace

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Re: Doctor's gory tale angers soldier's family
« Reply #2 on: August 04, 2007, 10:55:19 »
As stated in the News article, he would have changed the name, but as the name was so well known because of press releases, and the wide dissemination of the facts, there would not be much trouble in identifying the real person.  He did contact Cpl Megeney's mother and she was OK with releasing the facts.  That being the case, he has done everything reasonably possible in publishing the event.  I don't think it is necessary to ask the permission of other family relations, once, twice or even more removed, to print a story.  There was nothing derogatory in what he wrote.  He only wrote about what they did in a clinical manner to try and save a life.  If you are offended about things like that, then don't read any medical documentation, don't watch any medical shows, etc.  You have the right not to read medical documentation of procedures taken in an OR.

Next question, I beg to ask:  Did these family 'members' object to any of the descriptions of the other patients that he treated over there, or to his comments on how they treated mortally injured ANA soldiers?  NO.  They did not.  Seems that they are a little callus in their judgment of the Doctor.
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Offline Rider Pride

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Re: Doctor's gory tale angers soldier's family
« Reply #3 on: August 04, 2007, 12:37:29 »
He definitely could have done without mentioning the name.

But the publisher of t blog page did ask permission of the parents. G&M is trying to make hay of the uncles feelings...

If he has problems, he should take it up with his in laws.
« Last Edit: August 04, 2007, 12:43:16 by St. Micheals Medical Team »
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Offline ParaMedTech

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Re: Doctor's gory tale angers soldier's family
« Reply #4 on: August 04, 2007, 14:45:07 »
Very well written.

Could he have told it without the name or nationality?  Absolutely, but putting a name and a face to the account makes it that much harder hitting, brings it home: these are young Canadians, from small communities, in the service of their country.  They're your neighbors, your classmates, doing hard, dangerous work under appaling conditions at constant risk, because we as a nation have asked them to do it.

Kudos to the author for his writting, but also for his willingness to step out of his Vancouver Island hospital and take care of our troops.
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Offline 3rd Herd

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Re: Doctor's gory tale angers soldier's family
« Reply #5 on: August 04, 2007, 15:05:37 »
Rather than an article in a blog, would it not have benefited the Doctor and the family more if the article had been geared towards some facet of medcine and published in the CMJ. Or is the good doctor building the hype for the release of  "in Outside The Wire, an anthology of writing about Canada's Afghan military mission co-edited by Dr. Patterson, to be published this fall."
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Offline Nemo888

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Re: Doctor's gory tale angers soldier's family
« Reply #6 on: August 04, 2007, 15:57:24 »
(VENTING)Isn't the real issue that our "Hospital" is a piddly little shack with unpainted plywood walls? He didn't mention that the anaesthesiologist is also responsible for swatting the flies. Don't bother tubing ANA we'll need the bed for coalition forces. Didn't he have a family too?

But when it gets translated to the mainstream Canadian media it becomes, "How dare they name the soldier." I just don't get it.

(/VENT)
« Last Edit: August 04, 2007, 16:04:15 by Nemo888 »

Offline ParaMedTech

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Re: Doctor's gory tale angers soldier's family
« Reply #7 on: August 04, 2007, 16:13:14 »
I agree an academic article should probably come out of his (and others) stays in K'Har;  This is a human interest story, much as TLC's "Tales of the ER" is as much a human interest story as a look at the weird and wonderful stuff that comes through the doors.

As to the MMU being a "shack", we've been trying to get a better facility up and running for some time, but the pressure on real estate in KAF is pretty intense, and we don't have the space to build a new one while keeping the existing one up and running.
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Re: Doctor's gory tale angers soldier's family
« Reply #8 on: August 04, 2007, 22:49:30 »
the publisher of t blog page did ask permission of the parents.

Better yet, the woman is the publisher of the magazine, not just the web page - pretty high up the food chain to be contacting sources for a story.  As much as I gripe about MSM, I have to agree that she did her best to brace the folks.  Here's the publisher's response in full (with comments, so far, seeming to support what was done in total).

G&M is trying to make hay of the uncles feelings...

How unlike some MSM  ::)  We'll see if they publish the REST of the story anytime soon...

- edited to add MoJo Response link -
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Offline Greymatters

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Re: Doctor's gory tale angers soldier's family
« Reply #9 on: August 05, 2007, 00:15:00 »
I must have missed it, but who is complaining about the article?  I thought it rather well-written, and extending the courtesy of approval to the soldiers mother goes far beyond what your average keyboard-jockey shows a miliary member.  As previously stated, if you object to this kind of material, dont read it. 

Offline BulletMagnet

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Re: Doctor's gory tale angers soldier's family
« Reply #10 on: August 05, 2007, 08:38:53 »
The Role 3 in KAF though not luxurious by North American standards is a great place and the medics. doctors and nurses there do what they can to make sure people are comfortable. Could it stand to be concrete poured or in something sturdier, maybe bu it does it's job and does it well. I think the construction of the hospital is a non issue in my mind anyway.

If the publisher contacted the Mother and she was fine with the story going to print then really the rest of family hasn't say in it and the uncle really should STFU. I am betting, NO I know that families want to here how it is their loved one died and their last  moments they want the closer and I know as painful as it was to read it may have been the last little bit needed for the direct family.
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Offline Digger Hale

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Re: Doctor's gory tale angers soldier's family
« Reply #11 on: August 05, 2007, 21:47:12 »
I thought the story was fantastic, really well written and gave a great insight to the world that he lived in over there.
What is it with extended family members complaining about things? There was a story a little while ago of another uncle or aunt who kicked up a storm while the parents of the CF member killed supported the CF. I cant remember what it was all about though, only that i thought the uncle had no right to be doing what he was doing, especially seeing as the parents didnt feel the same as him and he seemed to be capitalizing on getting himself attention.
If the mother said "yes" then whats the issue? I'm sure there Christmas dinner this year will be a bit strained.
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Offline Blackadder1916

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Re: Doctor's gory tale angers soldier's family
« Reply #12 on: August 06, 2007, 01:14:31 »
First off, let me say that I think that the article in question is excellent; it’s well written, informative and entertaining.  However the controversy should not revolve around the fact that some family members objected while others may not have, or around the supposition that Cpl Megenny would have been identified anyway if Dr. Patterson had described the tragic events using a pseudonym.  As much as Dr. Patterson is a good writer (judging from the quality of the article), I must fault him for a lapse in his medical practice.  As a physician, he is (or should be) very aware of his responsibilities regarding patient confidentiality. He did not had express permission to divulge identifying patient information prior to submitting this article to the magazine.  That permission could only be given by the Corporal’s surviving NOK and according to the magazine the NOK had not been in contact with Dr. Patterson at any time prior to the publication of the article.  And as the information was not used for the purpose for which it was collected, he could not have assumed that he had implied consent.   It does not matter why he wrote the article, he violated patient confidentiality.  If he had written a story that included details about the medical condition of a patient from his civilian practice without permission he would be subject to penalties available under applicable personal info/health info legislation.  Why should the rules be different because of the circumstances of the patient?

As for the magazine’s supposed permission to publish this story identifying the Cpl,  the editor states that “First, we sent a letter to Cpl. Megeney's parents, uncle, and sisters, ahead of publication, informing them that this 7,000 word diary of a doctor's month of service at Kandahar Air Field did contain a scene involving the tragic death of their son.”  There is no specific mention that they requested permission ahead of publication only that she had spoken to the mother and sent copies of the (already completed) magazine article.
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Offline George Wallace

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Re: Doctor's gory tale angers soldier's family
« Reply #13 on: August 06, 2007, 10:32:46 »
Blackadder1916

Quote
Responding to the onslaught of criticism, Mother Jones's co-editor, Clara Jeffery, said in a posting on the magazine's website that she had contacted the family prior to publication and that Cpl. Megeney's mother had said that the article would help the family have closure.


This quote found in the Globe and Mail article doesn't quite match your interpretation of the facts.
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Offline --NES--

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Re: Doctor's gory tale angers soldier's family
« Reply #14 on: August 06, 2007, 10:49:52 »
Good Article... Well written and a good read.  But I don't see how Cpl. Megeney's part is any more controversial than any other portion of the article.

But in any case, as HitorMiss put it;
If the publisher contacted the Mother and she was fine with the story going to print then really the rest of family hasn't say in it and the uncle really should STFU.

Once the primary NoK has given consent to the author, any other issues arising should come down to the primary NoK... Meaning, if Cpl. Megeney's uncle, or any other family member, has an issue with the article, they should be taking it up with Cpl. Megeney's mother, not the author.
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Re: Doctor's gory tale angers soldier's family
« Reply #15 on: August 06, 2007, 11:29:46 »
As George Wallace pointed out, if the G&M and MoJo were quoted accurately, Mrs. M could be seen as consenting if she did, indeed, say publishing could assist in healing and closure.

I think some of the issue might be the fact that after MoJo contacted the mother and family, the Halifax Chronicle-Herald shared this quote from Cpl. Megeney's mother:

Quote
"I just wish I had seen it first," Karen Megeney, the dead soldier’s mother, said Friday.

That said, the next bit in the same piece is interesting....

Quote
Her family was away on vacation when the magazine sent them an advance copy of the article.  "It was on the stands before we even knew about it," Ms. Megeney said.

So, the magazine made what appears to be every effort to give the family a head's up, as well as share copy with the family (something MSM is normally HUGELY reluctant about doing).  It also appears that nobody had a chance to look the material over before it hit the streets/internet.

Blackadder1916 also hits the nail on the head re:  any investigations -- Did the doc do the right thing sharing information about one of his patients with the public? 

You can even take that two ways:
1)  Did he do the morally ethical thing in releasing patient information to the public?
2)  Did he contravene the CF's and GoC's various privacy laws and regulations in releasing patient information to the public?
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Offline Greymatters

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Re: Doctor's gory tale angers soldier's family
« Reply #16 on: August 06, 2007, 21:52:44 »
Blackadder1916 also hits the nail on the head re:  any investigations -- Did the doc do the right thing sharing information about one of his patients with the public? 

You can even take that two ways:
1)  Did he do the morally ethical thing in releasing patient information to the public?
2)  Did he contravene the CF's and GoC's various privacy laws and regulations in releasing patient information to the public?

Good points... although I dont believe any actual privelaged information was released, it might be argued that the military has the right and the need to approve 'real-life stories' published while an actual operation is still in progress, as this may have unit morale and public relations effects on the operation... but I think its difficult to actually pin down specific transgressions.

Offline Blackadder1916

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Re: Doctor's gory tale angers soldier's family
« Reply #17 on: August 07, 2007, 09:40:11 »
Good points... although I dont believe any actual privilaged information was released...,

If based on the privacy/protection of info legislation that Dr. Patterson may be subject to in his civilian practice (and accepted medical ethical practice), the privileged information is the patient's name and the simple fact that the patient was under care.   A military member also has the right to medical confidentiality just like a civilian (though with certain caveats).  Cpl Megenney (or NOK) did not waive that right or grant Dr. Patterson permission to use personal information collected for the purpose of  providing medical care.  How current CF/GoC regulations (and how well/badly the doctor's contract was written) are applied is another matter.  At the very minimum his breach of medical confidentiality should be reported to his college.
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Offline Greymatters

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Re: Doctor's gory tale angers soldier's family
« Reply #18 on: August 07, 2007, 12:56:55 »
If based on the privacy/protection of info legislation that Dr. Patterson may be subject to in his civilian practice (and accepted medical ethical practice), the privileged information is the patient's name and the simple fact that the patient was under care.   

This is not an attempt to spark an argument but consider this - the patients name was already in the public realm as was the nature of the incident which contributed to the patients condition.  As pointed out earlier, even with an oblique reference, people would have been able to figure out who the case was refering to.  And, it is not privelaged information to say which patient is under your care.     

Offline geo

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Re: Doctor's gory tale angers soldier's family
« Reply #19 on: August 07, 2007, 13:18:16 »
Considering the grizzly details we read about every day in our morning newspaper and watch on the evening news, I don't think Dr Patterson disclosed anything that wasn't already known through other means.... his delivery was probably a little rough for the Megenney family but, his description avoided sensationalism and told it like it is... err - was.
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Offline Blackadder1916

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Re: Doctor's gory tale angers soldier's family
« Reply #20 on: August 07, 2007, 16:50:09 »
...  And, it is not privelaged information to say which patient is under your care. 

Actually it is.  Common principles in all (Canadian) personal info protection legislation are that personal information is to be collected only as necessary to accomplish a specific purpose,  that the person about whom the info is collected is aware of the purpose and that disclosure of the info only be made in order that the purpose be accomplished.

I am more familiar with Alberta's Health Information Act (and have had dealings with representatives of Alberta's Privacy Commissioner in regards to health information complaints) but as I cannot access their site for some reason today, I will quote from the guide to BC's Personal Information Protection Act (BC does not have specific health info legislation like Alberta).
http://www.oipc.bc.ca/pdfs/private/a-_GUIDE_TO_PIPA(3rd_ed).pdf
Quote
Personal information means information that can identify an individual (for example, name, home address, home phone number, ID numbers), and information about an identifiable individual (for example, physical description, educational qualifications, blood type). Personal information includes employee personal information but does not include business contact information or work product information.
BC regulations may be more appropriate as (from what I got from the news articles) Dr. Patterson practices in British Columbia, so he should be familiar with the specific requirements of his jurisdiction.

As for disclosing information that is already in the news, that doesn't matter.  If a physician acquires personal information about a patient in the course of his medical practice he is bound by confidentiality, regardless what others may know about the patient.  If he is unable to tell his story without identifying a patient (and he doesn't have express permission from that patient to do so), then he doesn't (or shouldn't) tell the story.

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Offline ParaMedTech

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Re: Doctor's gory tale angers soldier's family
« Reply #21 on: August 07, 2007, 19:19:39 »
Not completely on topic here, but an excellent clearinghouse of information on the various pieces of privacy legislation is Privacylawyer.ca

I know he's done a fair amout of work with the CMA, CMPA and various provincial bodies, as well as international privacy law.

PMT

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Offline Blackadder1916

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Re: Doctor's gory tale angers soldier's family
« Reply #22 on: August 07, 2007, 22:04:45 »
My above post dealt primarily with privacy legislation as regards a physician's practice, but what about his ethical obligations.  However, ethics (or more so the practice of ethical behaviour) are a personal thing and difficult to enforce (thus we have legislation).  When privacy legislation was being proposed in Canada, the medical community did make many proposals that they should be exempt from some of the legislative mandates as they could meet the requirements due to their ethical obligations in the practice of medicine.  The Canadian Medical Association has compiled a Code of Ethics for use by Canadian physicians from which the following section is excerpted:

Privacy and Confidentiality

31.  Protect the personal health information of your patients.
32.  Provide information reasonable in the circumstances to patients about the reasons for the collection, use and disclosure of their personal health information.
33.  Be aware of your patient’s rights with respect to the collection, use, disclosure and access to their personal health information; ensure that such information is recorded accurately.
34.  Avoid public discussions or comments about patients that could reasonably be seen as revealing confidential or identifying information.
35.  Disclose your patients' personal health information to third parties only with their consent, or as provided for by law, such as when the maintenance of confidentiality would result in a significant risk of substantial harm to others or, in the case of incompetent patients, to the patients themselves. In such cases take all reasonable steps to inform the patients that the usual requirements for confidentiality will be breached.
36.  When acting on behalf of a third party, take reasonable steps to ensure that the patient understands the nature and extent of your responsibility to the third party.
37.  Upon a patient’s request, provide the patient or a third party with a copy of his or her medical record, unless there is a compelling reason to believe that information contained in the record will result in substantial harm to the patient or others.


I suggest that Dr. Patterson failed to meet the ethical obligations of his profession.  Hopefully it can be be shown that he failed to meet 'legal' obligations as well.
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Offline geo

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Re: Doctor's gory tale angers soldier's family
« Reply #23 on: August 09, 2007, 12:57:43 »
Meanwhile this is happening in the states...
The plastic surgeon who did Boob enhancements for Anna Nicole Smith is releasing (selling) the video to the public of the surgical procedure.  While the executor of her estate (Stern) is complaining & threatening, the MD is claiming that, once the patient is deceased, the caregiver confidentiality obligation ends.....

Without being the same situation.... similar ethical issues.
Chimo!

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Re: Doctor's gory tale angers soldier's family
« Reply #24 on: August 09, 2007, 13:27:32 »
once the patient is deceased, the caregiver confidentiality obligation ends.....


I have actually heard this before, many times and in many contexts (including the death of a close friend), as well as in movies and TV shows (I know.. not a good point of ref), but is this actually legal in Canada, is it a US thing, or is it just a steaming pile of movie magic?
I've been trying to find some kind of legal precedence or reference to this, in Canadian legal terms, and have been unsuccessful, especially since I don't know even whete to start looking.

Can anyone shed some light on this... 'cause if this is the case here in Canada, than this Doc is in the clear for sure.
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