The plaintiff had been confined to a mental hospital after killing several people by shooting. He complained that when he was to be considered for release, his psychiatrist, the defendant had broken his duty of confidence by revealing his concerns about the plaintiff to the secure hospital with his care, despite the plaintiff have withdrawn his application for transfer to a non-secure unit.
Held: A doctor’s duty of confidence to his patient and the need to preserve general reliance upon that confidence could be overriden where there was a real risk of violence to others. The maintenance of a duty of confidence between doctor and patient was not a matter of private, but of public interest, and that public interest was to balanced against a similar interest in protecting members of the public against acts of violence: ‘As between the competing public interest in the duty of confidentiality . . and the public interest in disclosure of the report, the balance came down decisively in favour of disclosure because the number and nature of the killings . . were such that decisions leading directly or indirectly to (the plaintiff’s release from a secure hospital should not be made unless the authorities responsible . . were properly able to make an inform judgment that the risk of repetition of the killings was so small as to be acceptable. Accordingly, since (the psychiatrist) had highly relevant information about (the plaintiff’s condition) he had been justified in passing it on to those responsible for making decisions . . because the suppression of that information would have deprived the hospital and the Secretary of State of information which was relevant to questions of public safety . . ‘
Bingham LJ said: ‘Only the most compelling circumstances could justify a doctor in acting in a way which would injure the immediate interests of his patient, as the patient perceived them, without obtaining his consent.’
Bingham LJ said: ‘It has never been doubted that the circumstances here were such as to impose on Dr Egdell a duty of confidence owed to W. He could not lawfully sell the contents of his report to a newspaper . . Nor could he, without a breach of the law as well as professional etiquette, discuss the case in a learned article or in his memoirs or in gossiping with friends, unless he took appropriate steps to conceal the identity of W.’
Bingham LJ, Sir Stephen Brown P Sir John May
[1990] 1 Ch 359, [1990] 2 WLR 471, [1989] EWCA Civ 13, [1990] Ch 359
Bailii
England and Wales
Citing:
Appeal from – W v Egdell 1989
The psychiatrist had been engaged by W’s solicitors to examine him and prepare a report to go to the Tribunal hearing an application for the transfer or conditional discharge of W from a secure unit. His report was damning. W withdrew the . .
Cited by:
Cited – Grobbelaar v News Group Newspapers Ltd and Another CA 18-Jan-2001
The claimant had been awarded andpound;85,000 damages in defamation after the defendant had wrongly accused him of cheating at football. The newspaper sought to appeal saying that the verdict was perverse and the defence of qualified privilege . .
Cited – Re C (A Child) FC 29-Sep-2015
There had been care proceedings as to C. The mother was treated by a psychiatrist, X, and an associate Y. They also prepared expert reports. M formally complained about X, and the charges having been dismissed, the doctors now sought disclosure of . .
Lists of cited by and citing cases may be incomplete.
Updated: 28 July 2021; Ref: scu.381731
