Removing D*ugs from "Very Private Place"... An Ethical Dilemma?

Подписаться 638 тыс.

Просмотров 11 тыс.

50% 1

A dangerous and interesting foreign body removal resulted in an unusual ethical dilemma. One of my GI partners at Esse Health, Dr. Bialecki, describes a wild case. Details of the case have been altered or limited to protect privacy and anonymity.
For more Doc Schmidt content, check out my website: www.docschmidt.org/
Subscribe to my fun weekly newsletter (for free!): eepurl.com/iaYycn
To check out a previous newsletter, click here: mailchi.mp/a9909f90caca/why-a...
Check out my children's book here: www.amazon.com/Night-Before-M...
Logo and graphics designed by iamlindaayoade.com and loigraphics.com (LOI Graphics Inc.)
Want me to make you a personalized video for you or your friend? Check me out on Cameo!
v.cameo.com/DFKBSe2HSib
Want to connect with me and watch more content?
Find me on TikTok!
vm.tiktok.com/ZMRFmqKts/
And Instagram!
docschmidtig?r=...
All content is intended as medical education or entertainment and is NOT intended to be medical advice. If you have any symptoms concerning you, please schedule an appointment with your doctor.
Join my channel to get access to perks! Click link below:
/ @doc_schmidt

Приколы

Опубликовано:

7 ноя 2023

Ссылка:

Скачать:

Готовим ссылку...

Добавить в:

Мой плейлист

Посмотреть позже

Комментарии : 95

@tulipp3666 6 месяцев назад

I work in the emergency department and whenever we find substances on patients we seal them in an envelope, write a description of the contents on the outside, and send them to the hospital pharmacy to be safely disposed of. Finding things like this is quite common and you don't need to involve the police.

@EngageYourFrontalLobe 6 месяцев назад

Pharmacists can NOT legally accept illegal drugs.

@bosstowndynamics5488 6 месяцев назад

Figured I'd just clarify some facts that a lot of the "obviously you should just dispose of the drugs yourself and not tell the police anything" people seem to have missed: 1) this is a 2 minute short video, it's quite likely that the Dr did in fact seek legal advice, and even in this short video it's pretty clear that other options were explored 2) doctor patient confidentiality isn't a magic get out of jail free card, police can still compel testimony and obtain evidence with a warrant, which was more than likely involved. The patient might not have been identified at all until a warrant was involved forcing the issue 3) Yes, I'm sure you've seen small quantities of drugs disposed of, but it's pretty clear here that the quantity in this case was a lot more than personal use quantities 4) it's kind of very illegal for doctors, clinics and hospitals to possess large quantities of heroin, and safely disposing of drugs is substantially more complex than just flushing them down a toilet. No hospital pharmacy in their right mind is going to accept a kilo of heroin for disposal.

@muirgenmonet 6 месяцев назад

You are absolutely correct. When the doctor wrote the operative note he would either have to lie (which is o obviously bad) or mention that he found and removed other foreign objects as well. Objects/specimens that were not sent to pathology. Our clinic policy may allow the disposal of opioids with a signing witness, but how the heck would the proper disposal of heroin- and that quantity- be properly disposed of by staff? Also, the ED may have protocols, but finding drugs on patients in the OR is probably not a frequent occurrence.

@GM_Alexandria 6 месяцев назад

I would have hoped in a situation like this you could turn the items into the police while refusing to tell them where it came from under Dr/patient confidentiality.

@yuvalne 6 месяцев назад

this exactly.

@PrayingToTheAlien 6 месяцев назад

Depends on the state - but since it was potentially a felony, Dr/patient confidentiality may not apply.

@4and20blackbirdsbakedinapi6 6 месяцев назад

If we did that, we would take the rap for obstruction of justice, and the consequences are devastating.

@catBoi_Finnbjorn 6 месяцев назад

If your intent was to prevent the authorities from finding the illegal substances and prosecuting the patient then it might be considered obstruction. If the cops aren't there in the room just open them out of the plastic (wear gloves ofc) and flush them and say you knew the drug was dangerous and were simply disposing of it. As always consult a criminal defense lawyer in your specific location. @@4and20blackbirdsbakedinapi6

@laurann27 6 месяцев назад

This exactly. It is not obstruction because you are legally obligated to maintain confidentiality

@andrewtischler9385 6 месяцев назад

Should have asked the hospital's counsel for direction & advice, I'd think.

@GettingThereGreenGTG 6 месяцев назад

Is there not a hospital ethics committee that can decide on whether or not to call the police so it isn't all resting on this one doctor's hands and conscience? Or not enough time for that?

@bosstowndynamics5488 6 месяцев назад

It's perhaps worth noting that this is a 2 minute short and probably left some details out, details that likely include legal warrants and probably legal counsel

@tonymouannes 5 месяцев назад

It probably that he got worried that he would get in trouble if the police learns about the drug from a different channel. Unless the hospital had a specific policy that he was aware of, he could have been at risk of getting arrested himself for drug related charges.

@jfat4 6 месяцев назад

Rectum Area and Beyond: For all your home decor and GI needs

@CallieMasters5000 6 месяцев назад

You can tell he loves telling this story.

@jmorones 5 месяцев назад

Would you say he finds it exciting?

@CallieMasters5000 6 месяцев назад

Um, Doc, when this doctor starts making videos for his OnlyFans account, he'll know to call you to do all the filming. 😳

@alloralou4722 6 месяцев назад

😂😂😂 yup

@williamloftin5793 6 месяцев назад

😂😂😂

@noneyabid 5 месяцев назад

It took me 4 viewings to actually hear the story. 🤣

@TheAmtwhite 6 месяцев назад

Why didn’t he just call the police to pick it up, but refuse to identify the patient?I thought patient privacy is always to be respected.

@catsrule8844 6 месяцев назад

Why do the cops need to know at all?

@TheAmtwhite 6 месяцев назад

@@catsrule8844 In the video, it’s because no one else wanted to touch it/deal with its disposal or storage at the hospital.

@tonymouannes 5 месяцев назад

You can't call the police to snitch about finding drugs and hiding the person's identity. Also the police would want to find out where it came from and might start accusing the staff.

@franny5295 5 месяцев назад

Now you know...

@Ninjafruit111 6 месяцев назад

We have a protocol for handling unknown substance in our ED. If it is limited quantity and for pt's personal use, the team can contact pharmacy to destroy it. For larger quantities that might be for distribution, police needs to be involved.

@bosstowndynamics5488 6 месяцев назад

It's pretty clear that the amount involved here was substantially more than a typical personal supply

@stephenleblanc4677 6 месяцев назад

Well, patient privacy should be paramount. You could have turned over the H to the police without identifying the patient. You could have given the patient a receipt for the H that you got from the police. Unless there is a specific law on the books REQUIRING you to id the patient, don't.

@wangwang29000 6 месяцев назад

In country where you are required having a helth inssurance, the patient is expected identified, doesn't matter what. There is also a whole bunch of reason to visit subject to disclosure with authorities, like infectious desease

@bosstowndynamics5488 6 месяцев назад

@@wangwang29000Health insurance doesn't require you to identify the patient in police encounters, even the US doesn't send a bill to people for being arrested. What I suspect could have happened though is that the patient wasn't identified initially but the police brought a warrant or some other form of legal demand to obtain that information, which does legally negate patient confidentiality.

@alisonhewitt1753 6 месяцев назад

Perhaps a camera angle showing above the waist next time?? 🤣🤣

@CallieMasters5000 6 месяцев назад

Like is this TikTok or DikDok? 😂

@lisab3706 6 месяцев назад

I enjoyed it 😊

@missdirectedawakening 6 месяцев назад

😂

@bradlemmond 6 месяцев назад

This is the comment I was looking for. 😂

@Samuraistar92 6 месяцев назад

That’s a very interesting story. I’m glad you did the right thing. Great job doc. That must have been a difficult situation but you handled it gracefully but also did the best you could.

@Katm0m 6 месяцев назад

I love these stories! Both parents are MDs so I miss their medical tales

@Twinkie989 6 месяцев назад

I worked with a doctor as a camp counselor back in the day. His best stories were about what he removed from rectums. Never disappointing. Sounds like the bags already burst in the jail- so I am sure they knew who it was, anyway.

@Jdog4588 6 месяцев назад

If the case didn’t settle could you he have invoked doctor patient privilege or was that already violated when the cops came?

@saragates2255 6 месяцев назад

Good question... I'm curious, too

@yuvalne 6 месяцев назад

@bosstowndynamics5488 6 месяцев назад

Doctor patient confidentiality isn't anywhere near as strong as attorney client privilege, it would be trivial for the police to get a warrant to obtain identifying information in a court with a big load of smuggled heroin, and once they've got that information it's pretty easy to convince a court to compel testimony

@laylagardner8728 6 месяцев назад

That is such a violation of confidentiality. Congratulations, you just convinced me to never seek medical help for an OD.

@Doc_Schmidt 6 месяцев назад

I certainly understand your concerns but this situation was incredibly unusual and involved far more complicated ethics than a typical overdose

@deborahfairbanks4012 6 месяцев назад

Remember, he stated this was years ago. Things have changed, I might imagine...

@autgoff 5 месяцев назад

Send it to pharmacy, they'll dispose appropriately

@tobybartels8426 6 месяцев назад

Hopefully the hospital instituted some procedures afterwards so that contraband could be handled in the future without violating patient confidentiality.

@keard558 6 месяцев назад

Give it to pharmacy

@fluffyfury1616 6 месяцев назад

Yea. I get it. Protect your people. But I'm sure the hospital had a lawyer on call who could have created a good outcome for everyone.

@69waybetter 3 месяца назад

Crazy story!

@ferretyluv 6 месяцев назад

Does he not wear underwear or something?

@mccnt9918 6 месяцев назад

I would've never noticed if you didn't point it out. I can't unsee it now. Thanks Buddy! Lol

@missdirectedawakening 6 месяцев назад

Once it was seen, I couldn't hear words. I just paused and had to know if I was the only pervy one 😅 but really... the video is poorly shot. This is why zooming happens from the waist up.

@ferretyluv 6 месяцев назад

@@missdirectedawakening I mean, it looks very nice. It’s just… as Gunther said, keep the mouse in the house.

@vjara92 6 месяцев назад

You have to protect your staff, or you could be charged with hiding evidence, you are responsible of the health of the individual but not of his decisions. We need more of this doctor and this camera angle 🤭

@megana5658 5 месяцев назад

😂😂

@barbaragremaud3499 4 месяца назад

I just commented to avoid this angle in the future 😂!

@Anuyushi 6 месяцев назад

Its such a difficult decision but honestly I think you made the right call. It wasnt a normal overdose situation and the amount removed was a risk to everyone involved in the situation. Confidentiality definitely applies when the drugs are in the system and they're working with an overdose, but it's a different situation when so much is removed from a patient in bags. Not a safe amount to dispose of and scary for everyone that its passed off to. The drugs being in the possession of the hospital is enough to contact the police for disposal, although I wonder why the police needed to know exactly which patient they came from.

@jojothetasmaniansassmonkey8866 6 месяцев назад

couldn't he have just given the drugs to the police and then refused to divulge the patients identity due to hipaa laws?

@GMW.artist 6 месяцев назад

The only time ive had drugs shoved up there, was by Doctors! 😂

@catBoi_Finnbjorn 6 месяцев назад

Patients hear about this and decide they'd rather OD than go to the hospital. Esp. the hospital with the doctor who will not only call the cops but will also testify against you YEARS LATER. What did this patient ever do to you anyway Dr. Bialecki? For the uninitiated I can understand not knowing what to do but this is a seriously skewed and harmful action. You can call hospital counsel or ethics who will likely advise you to not call the police as it's a breach of confidentiality and trust. Or you can try asking for someone who can dispose of harmful drugs (pharmacy?). Ask a criminal defense lawyer before safely flushing the drugs about the laws in your area. Obstruction of justice is not applicable typically if your intent (mens rea) is to just dispose of the drugs since they are harmful and dangerous. You are never required to call the police, never talk to the police always have a lawyer present before making any statements.

@bosstowndynamics5488 6 месяцев назад

It's actually very illegal to flush a kilo of heroin down the toilet, and also very illegal for doctors to possess a kilo of heroin even if they obtained it in the course of their duties. Remember this is a 2 minute short describing legal events that took place over years - I'm pretty sure there's more to it than just "Eh, I called the cops because IDGAF", particularly since a significant part of this is the Dr explaining how much he didn't want to involve the police at all.

@catBoi_Finnbjorn 6 месяцев назад

I'm pretty sure removing the drugs and saving the patients life isn't illegal. At least holding the heroin for the time to put it in the specimen tray definitely isn't. Take Nebraska for instance, I'm not sure there's a specific law it comes under but then ofc. I'd consult a lawyer beforehand. Looks like you'd have to record it's destruction maybe after a cursory search through the revised statutes. Do you know what law that would be on flushing (unpacking, cutting open so they aren't still sealed 'balloons' and flushing multiple times)?@@bosstowndynamics5488 ??

@MikeBreytenbach 6 месяцев назад

You need to censor the word drugs in the title? Why?

@JM-ig4ed 4 месяца назад

How do the bags even get in there to start with? I mean the mechanics of it - imagine shoving them up there - but yikes that would take some work.

@cames1132 6 месяцев назад

Not saying if the way this was handled was correct, but think about this: Years ago things were handled differently. That may be the case here. It seems nobody else knew what to do either. Now imagine you are responsible for this “specimen”. The patient is under the influence of illegal and possibly medically necessary meds and can’t make any legal decisions Don’t think handing a “specimen “to the patient’s family is correct If you opt to hold on to this until you hear from legal, have other patients to see and then you lose it, you’re responsible. There is always a curveball thrown at you no matter how thorough policy and procedure manuals are- been there, done that, fortunately my resources came thru in a timely fashion.

@cmygamelife 6 месяцев назад

Do you know about traumatic brain injuries?

@BohoAstronaut0201 5 месяцев назад

Wow that is so disappointing. I had always told people i knew you cant get in trouble for calling for help. And this dr did. What a smug little brat.

@youtubelabeledmeapredator826 6 месяцев назад

Stay away from my bum🤣😂🤣😂🤣😂🤣

@franny5295 5 месяцев назад

Dude, you're forgiven being naive once. Now you know... Edited to add: This only validated my position that doctors should be avoided unless you're reasonably sure you're going to die if you don't go.

@thisisyourcaptainspeaking2259 16 дней назад

This patient doesn't represent a danger to others?

@blancaochoagarcia7286 6 месяцев назад

😮

@JimDixon55104 6 месяцев назад

I believe there is a law in my state stating that you can't be prosecuted for the drugs that are inside yoor body, the reason being we don't want people to be afraid to ask for help when they have overdosed. This should be the law everywhere.

@PixelGem7 4 месяца назад

Whose horse is that?

@JohnDoe-my5ip 5 месяцев назад

Just flush it smh

@tofuresearcher5958 6 месяцев назад

Is this legal? Where I come from, calling the police in this situation would be a breach of doctor patient confidentiality. Because there are no grounds to believe that any crimes of particular gravity are planned, smuggling drugs would not count, you would not have been allowed to disclose this patient information to police.

@carolinecardwell2163 6 месяцев назад

what a narc

@kathrynpassmore5425 6 месяцев назад

Thank you for your self serving ’honesty’ here even though it is MORE than obvious it was only to dampen your own personal guilt. This was very disturbing. And yet society wonders why so many that NEED help don’t trust ‘those’ they are ‘supposed too’ trust to help them? At least you are helping others in need to choose certain death, rather than prison. This will be of great help to MANY who otherwise would have been betrayed by a ‘trusted professional’ such as you. Is this why you do RU-vid these days?

@Doc_Schmidt 6 месяцев назад

I don’t honestly understand exactly what you’re trying to say here but this is an INCREDIBLY unusual circumstance where the patient’s actions led to the involvement of many more people than a typical doctor-patient relationship (where a patient discloses recent drug use during an interview for example). The doctor was also trying to protect his staff and didn’t see another viable option. I’m not saying it was the right call necessarily but it’s the decision that was made. The tone of your Monday morning quarterbacking is not productive.

@tonymouannes 5 месяцев назад

@@Doc_Schmidtso many people don't understand the implications of possession of a serious amount of illegal drugs. Storing those drugs can mean trouble. It would be nice to get the hospital's perspective and maybe a lawyer about what would have been the best practice in this situation.

@tiffytatortots1278 5 месяцев назад

Woof all the people wanting to protect the guy with drugs shoved up his ass and not the medical staff who had to deal with it. Listen live by the sword die by the sword you want to take the risk you deal with the consequences. As stated he had numerous bags up there, one had literaly ruptured causing an OD, meaning he was distributing them as stated by people out in the waiting room not just waiting for him but what he had. Get better standards people.

@onumaytuu 6 месяцев назад

You got yourself into this case too deep . The drugs were part of the patient's belongings. Let the police find find out on their own . Confidentiality and privacy issues were not maintained . You look so relieved that you did not have testify ! Why ?