In a move that has alarmed doctors for its breach of trust implications, the Punjab Police knocked on the doors of drug de-addiction centres across the state at the end of June, demanding details of patients, including names, addresses and telephone numbers.
On Wednesday, the Indian Psychiatric Society and Indian Association of Private Psychiatrists wrote to the Department of Home Affairs and Justice, the Health Department and the Special Narcotics Cell, asking that the police be directed to stop looking for this information.
The police had sought records from government and private de-addiction centres on four days, from June 27 to 30. The letter states that Punjab Police officials visited different drug de-addiction centres and demanded that the doctors in charge disclose patient details. The police officials did not produce any written order, circular or legal document in support of their demand. Neither could they name any case under investigation where production of relevant documents may be authorised by law.
When contacted, Ishwar Singh, Inspector-General Special Narcotics Cell said, “Only shareable data is being sought. The data which we can seek as per the law is being taken. We ask for data like the total number of patients. It is a routine practice.”
However, the owner of a private de-addiction centre in Punjab recalled how the police in his area ramped up pressure on him to part with patient details, backing off only after he spoke to a senior official in the state police. “The SHO landed up at the Centre and berated me for not sharing the details. He told me lots of others had already shared the information… The SHO’s concern was that he would look bad in official meetings for not having got the details,” said the owner, who did not want to be identified.
A constable in uniform sat outside the clinic for three days. Later, two senior officials returned with the SHO demanding the information. The doctor, who said the pressure on him was “enormous”, had to approach a top official in the state police force.
“Even he did not appreciate what I was trying to say. He offered to get a letter from the Medical Council of Punjab waiving the confidentiality requirements for de-addicition centres,” said the doctor.
Drug addiction, apart from being a big problem in Punjab, is a contentious political issue as well. On Monday, the state government told the Punjab & Haryana High Court that around 3 lakh drug users approached drug de-addiction centres as outdoor patients and more than 13,000 were admitted.
There is concern that if the police have managed to get patient information from de-addicition centres that buckled under the pressure, there could be a potentially disastrous impact on de-addiction programme in the state.
“If police want the number of patients at a centre, and other general information about what substance abuse is most common, we are more than happy to share that. But we cannot share any other information about patients that will erode the trust in the doctor-patient relationship completely,” said Indian Association of Private Psychiatrists President Puneet Kathuria.
It was not clear, Dr Kathuria said, what the police intended to do with the information, but one explanation could be that they wanted it to track down users and question them about where they had bought the substance, possibly in an effort to target supply chains.
Dr Kathuria said if doctors shared patient information, it would place the entire de-addiction programme in the state at risk. “Addicts will stop coming for treatment,” he said. One of the main questions that addicts have, he said, whose refusal to part with the information angered his area SHO, was about confidentiality. “Many have not even told their family about their problem. They certainly don’t want cops going to their villages and asking about them,” he said.
The representation from the two psychiatrists’ associations says the “damaging consequences” of the police action are already starting to be felt, with incidents of patients dropping appointments at the centres.
A doctor from a government rehabilitation centre, which had also been approached by the police for patient information, offered another explanation. The police had told the centre that they wanted to determine if the supply chain had been broken. When that happens, there is an increase in the number of patients at de-addiction centres. The doctor said the centre only shared data about the number of patients and the substances to which they were addicted.
Under the Punjab Substance Use Disorder Treatment and Counselling and Rehabilitation Centre Rules, 2011, the records of the patients are to be kept confidential. The Special Secretary, Health, Punjab had in a communication on November 12, 2014 directed all psychiatrists not to disclose information regarding drug de-addiction to the police without taking prior approval from the government.
Data from all de-addiction centres of Punjab is sent every month to the Institute of Mental Health, Amritsar.
In their letter, the psychiatry associations have stated that as per the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002, “Confidences concerning individual or domestic life entrusted by patients to a physician and defects in the disposition or character of patients observed during medical attendance should never be revealed unless their revelation is required by the laws of the state.”