In March, 2004, the Canadian Medical Protective Association issued an information sheet on how physicians should respond to a variety of situations, such as theft of prescription pads, theft of drugs, altering of prescriptions, or evidence of double doctoring for purposes of obtaining narcotics. The advice does note that College policies on this matter vary from province to province. To assist physicians in this regard, Council wishes to point out differences in the way New Brunswick physicians are expected to respond to these circumstances.
Council, first of all, notes the significant social problem of misuse and redirection of narcotics. There is a strong cost to society, both in terms of the effect of narcotics themselves, and the associated crime against persons and property. For this reason, Council expects physicians to acknowledge their general obligation to society and to recognize that there are situations where such may overcome their obligations to specific patients. In this regard, physicians should respond carefully when they become aware that a patient has altered a prescription, or has used other means to obtain narcotics illegally, such as double doctoring. Each case may be judged on its own facts, but Council wishes to remind physicians that if they issue further narcotic prescriptions to patients, when they are aware of such potential difficulties recurring, they place themselves at risk of being considered participants in illegal activity. As a consequence, when there is clear evidence of such, it is, in most cases, acceptable to deny all further prescriptions for narcotics and, furthermore, to discharge the patient from the physician’s practice without further notice. At the same time, Council feels physicians do have an obligation to society as a whole and, consequently, should not resist assisting the police with investigating such matters. Council also accepts that providing such assistance may require the physician to disclose confidential information.
In any case, Council appreciates that these situations are difficult, both personally and ethically, for physicians. To that end, physicians are encouraged to contact the College for any assistance when such matters arise.
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