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Interesting Ethical Dilemma

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Okay, I've haven't run into this situation before.


Patient X appears with a new onset of post traumatic headache X 3 months, SP a fall in a local coffee shop. On the first visit I completely focused on the patient, the exam, the history and giving him the best care. He did voice his anger towards the coffee shop owners and their negligence. We live on an island that has about 12 coffee shops (this is the Northwest).


Second visit more of the same. He did tell me that he has launched a suit towards the coffee shop.


Yesterday, he made it clear that it was coffee shop "A," which is owned by a good friend of mine. Then he went into a rant about how careless they were, how bad of people they are. I just listened professionally. But then he said that his lawyer will be calling me this week and that I will be asked to testify in court.


I imagined in my mind for a minute, me sitting in court, saying hi to my good friend the shop owner, then it being disclosed that am one of his best friends. If I don't say exactly what the patient's lawyer wants me to say, he will make an issue that I am being biased because I am the shop owner's friend. I just testified in court for a similar case in May so I know how it can go.


So, yesterday as he was ranting about the coffee shop I paused and told me, "You know, my biggest concern is that you get better. But if you are asking me to testify in court you should let your lawyer know that the coffee shop owner is one of my best friends."


How would you have handled it? Have you ever faced such a situation?

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I think you did the right thing by telling him of the relationship. He can now get another opinion if he wants. It would have looked bad if you had kept that info to yourself once you were aware of it. Chances are pretty darn good that he will get a settlement anyway, as the precedent had already been set many times that if a person gets injured in a place of business, the business usually ends up paying, even when the injured party did something stupid or deliberate that resulted in the injury. Hopefully the insurance will deal with it.

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You did fine.


Additionally, are there any tests that can prove/disprove malingering for his diagnosis?


It is a long story, too complicated to discuss here, but the best help in his situation was sending him through a very good neuropsych testing program run by a local psychologist.

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