Petition backing NUH psychiatrist went offline after drawing over 2,000 signatures

SINGAPORE — More than 2,000 people, mostly doctors, have signed a petition in support of psychiatrist Soo Shuenn Chiang of the National University Hospital (NUH), but it was no longer accessible online on Friday (March 8) evening — just a day after it was put up.

The reasons for this were not immediately clear and TODAY could not reach the person who started the petition, which urged the authorities to review a ruling by the Singapore Medical Council (SMC) against Dr Soo.

The psychiatrist was fined S$50,000 for failing to verify a caller’s identity before he wrote a memo referring a patient to the Institute of Mental Health (IMH). The caller turned out to be the patient’s brother and not her husband as he had claimed.

In its grounds of decision released on Tuesday, the council’s disciplinary tribunal found the psychiatrist guilty of failing to maintain patient confidentiality.

The petition in support of Dr Soo, titled “Justice for Dr S”, gained ground quickly after it was started on Thursday, drawing 2,026 signatures by 3.20pm on Friday. Later in the day, however, the weblink showed a non-existent page. 

At the same time, a separate petition went online, urging the SMC to consider the ruling’s impact on medical practice. It argued that the majority of caregivers acting in patients’ best interests would be shut out from receiving information “in the name of protecting confidentiality”.

By 9.10pm on Friday, there were 363 signatures for this other petition.

This is the second time in recent months that the medical community has rallied around one of its own in the aftermath of what they felt was an unfair ruling.

Last month, the Ministry of Health (MOH) said it had asked the SMC to review its ruling on Dr Lim Lian Arn, an orthopaedic surgeon who had been fined S$100,000 for failing to obtain informed consent from a patient before giving her an injection.

Dr Lim’s case triggered alarm among doctors here and some of them petitioned against the harshness of the fine.

Thursday's petition to review the ruling against Dr Soo was started by psychiatrist Ganesh Kudva.

In it, Dr Kudva said that the legal and ethical issues arising from the case were “ambiguous at best, but what isn’t ambiguous is the harshness of the punishment that has been meted out”.

“The ruling muddies the waters of balancing confidentiality and risk, and may even affect patient care moving forward, as one can no longer be sure of what the benchmark is any longer,” he added.

“What’s happened to Dr (Soo) could have happened to any of us and each of us could be in the dock one day unless there is some systemic change now.”

When approached on Friday morning, Dr Kudva declined comment. Attempts to reach him to ask about the petition’s offline status later in the day were unsuccessful. 

TODAY has contacted the MOH for comment.

THE CASE IN BRIEF

On Jan 19, 2015, a female patient was admitted to the NUH for an overdose of a pain-relief drug.

She was noted to have a risk of self-harm, as she had a history of depression.

Two months after she was discharged, Dr Soo received a call from the woman’s brother, claiming she was suicidal and needed an assessment at the IMH.

Dr Soo, the clinical director of the NUH department of psychological medicine, did not check the caller’s identity by asking for his name, identity-card or contact numbers, and comparing these against the hospital’s records.

The memo he wrote contained her confidential medical information, and he instructed his clinic's staff member to give it to the caller, believing he was the patient’s husband.

The memo was addressed to ambulance crew or the police officer-in-charge, but the brother used it to support his application for a personal protection order against the patient. The Family Court granted the order.

Dr Soo’s lawyers argued it was an “honest oversight” during the course of seeing 17 patients that day.

FINE TOO HARSH, FELLOW DOCS SAY

Doctors who rallied behind Dr Soo felt the fine was overly harsh and he had acted in good faith in protecting the patient.

Dr Adrian Loh, a consultant psychiatrist, said that he signed the petition because the verdict was “excessively condemning” of Dr Soo, whom he called a compassionate and well-respected psychiatrist.

While Dr Loh acknowledged there was a breach of confidentiality, he said psychiatrists who are told that a patient with previous self-harm behaviour was suicidal would do their part instinctively, so that the patient gets urgent medical attention.

“This has taken place in a circumstance which numerous doctors have themselves been through — that is, during a period when they have many different patients to try to help, they may have inadvertently assumed the genuineness of the help-seeking relative,” Dr Loh said.

Agreeing, psychiatrist Lim Boon Leng said that doctors are trained to respond quickly and at times, automatically, to help patients — particularly in time-sensitive situations such as suicides.

“It is necessary that more be explored with regard to the balance between patient and public safety versus confidentiality,” Dr Lim said. 

Another psychiatrist, who declined to be named because his employer does not allow staff members to speak to the media, said that it is almost impossible for doctors to verify a caller’s identity in a clinical scenario.

This is because a relative could have obtained information, such as the identity-card number of a family member he is impersonating.  

The ruling, he added, has sent fear through the medical community. “We are now more cautious about giving a memo to relatives,” he said.

He cited the example of a couple undergoing a divorce. “Will passing one memo to the wife be used against the husband on the custody claims of a child?” he asked.  

Dr Loh suggested that verification should primarily be the responsibility of hospital telephone operators or the clinic's staff members, who should be equipped with the necessary training and resources.

Dr Soo did not respond to TODAY’s request for comment.