A nurse specialist provides consultation to the surgery department of a hospital. The patient she visits there is agitated because of pain and financial worries (because he won’t be able to work for several months).
Text: Shirin Slabbers
The nurse specialist asks the patient whether she may contact his general practitioner to discuss medication advice. The patient then tells her that the GP has been prescribing methylphenidate and oxazepam for years, which he resells. The patient thus earns a nice amount per month. The patient indicates that the nurse specialist may only contact the general practitioner if she does not tell him this. The nurse practitioner wonders what to do. She expects her conscience to suffer if she doesn’t act on the information.
It is an offence, as a patient, to resell medication that requires a prescription. The Code of Criminal Procedure states that anyone who is aware that someone has committed a criminal offense is authorized to report it. There is even an obligation to report a number of serious crimes. This obligation does not apply to the resale of medication. This obligation to report does not apply in any case to doctors, nurses and other healthcare professionals with a professional secrecy, because they have a right of nondisclosure arising from their professional secrecy.
If a care provider learns during a treatment of a patient that he has committed a criminal offense, this is covered by professional secrecy. This may only be reported if the interest served by filing a report is greater than the interest of confidentiality. There must then be valid reasons to believe that breaking the secrecy is the only way to prevent serious damage. The care provider can even act disciplinaryly culpable if he does not do so.
If the patient still has a stock of medicines that he wants to sell, the declaration can prevent a danger to the health of the (potential) buyers. In my opinion, the GP may be informed, regardless of whether the patient still has a supply. After all, there is nothing to indicate that the patient will stop asking for medication and selling it on. It is recommended to first ask the patient whether he or she would like to tell his general practitioner. If he is willing to do so, a check must be built in (if he has really been told). If the nurse specialist tells the GP herself, she must first try to obtain permission for this.
Finally, no more information may be provided to the general practitioner and the police than is necessary to avert the danger to others. This is the solution to the felt conscientiousness.