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January 14, 1974

Whither "Nil Nocere?"

Author Affiliations

Springfield, Mass

JAMA. 1974;227(2):202. doi:10.1001/jama.1974.03230150050022

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To the Editor.—  In the issue of Oct 20, Dr. Hussey commented editorially on the controversy between Dr. Blumberg and Dr. Szasz on the ethics of experimenting without the full knowledge and consent of the subject.Obviously, tests on urine do no physical harm to the patient. However, "nil nocere" must be given wider interpretation. I have been advised by several attorneys that few, if any, states recognize a patient-physician privilege of confidentiality. Certainly Massachusetts specifically provides that physicians can be forced to testify over a patient's objection. Therefore, it is inescapable that drug (abuse) determinations, without the consent of the patient, can readily produce legal evidence against him. Dr. Blumberg's answer (quoted in the editorial), "Since our procedure did not affect the patients in any adverse way...." is therefore erroneous. I do not wish to put words into Dr. Szasz's mouth, nor do I wish to impugn Dr. Blumberg's