What is a care provider allowed to do if a patient tells during a therapy session that he may have been involved in the deaths of twenty people? That question was central on Friday during a series of disciplinary cases against six employees of GGZ Drenthe.
The Regional Disciplinary Board for Healthcare (RTG) in Zwolle not only revolved around one former nurse from the Wilhelmina Hospital Assen (WZA), but also about a much broader issue: how far does the professional secrecy of healthcare providers extend?
The nurse reported to the mental health service at the end of 2022. He was stuck after work during the corona pandemic and said he was struggling with trauma complaints. The images of dying patients kept coming back. It was barely possible to sleep anymore.
What was discussed during the subsequent conversations set in motion a chain of events that ultimately led to a police investigation, six weeks of pre-trial detention and now a day-long series of disciplinary cases.
According to the care providers involved, the nurse said that during the pandemic he had independently made decisions that ended the lives of patients. He is also said to have indicated that he would act this way again in similar circumstances.
This set off alarm bells for the practitioners. “If someone says he has done this twenty times, you have to take it seriously,” one of the psychiatrists involved said on Friday.
Discussions, consultations with colleagues, legal advice and consultations with experts followed within GGZ Drenthe. Ultimately, it was decided to break the professional secrecy and inform the WZA in Assen.
That decision was the turning point. The hospital filed a report. The nurse was arrested and imprisoned for six weeks. Ultimately, the Public Prosecution Service (OM) decided to dismiss the case due to lack of evidence.
For the former nurse, this is where the conviction began that mental health care had not helped him, but had actually caused him problems. During the hearing he spoke visibly emotionally about that period. “I came for help and left in handcuffs.”
According to him, everything revolved around a misunderstanding. He states that his statements were taken out of context and that the practitioners drew conclusions too quickly without conducting sufficient research into his situation and his psychological complaints.
His lawyer Ronald Knegt argued that the healthcare providers should never have broken their professional secrecy. There was no consent, although he also believed that the act had been negligent. For example, conversation reports were drawn up afterwards.
Healthcare providers look at the same events in fundamentally different ways. According to them, it was not an ordinary treatment relationship, but an exceptional situation in which two interests clashed: professional secrecy versus the responsibility to prevent possible danger to others. That dilemma ran like a common thread through all six cases.
Several practitioners stated that they believed the nurse. According to them, his story remained the same in several conversations. Moreover, he is said to have said that he would act that way again when he saw people suffering unbearably. That is precisely why they felt that doing nothing was not an option.
However, the disciplinary board was not entirely convinced. The chairman wondered several times why the hospital was informed so quickly. At that time, the nurse had not worked for months in the department where the events allegedly took place.
Why wasn’t more research done first? Why were no further attempts made to keep him in treatment? “He came for help,” the chairman told the care providers involved.
In particular, the question about the alleged acute danger continued to recur throughout the day. The care providers pointed out statements made by the former nurse about possible future actions. The disciplinary board wondered how concrete that risk actually was.
At the end of the last session one of the most striking moments of the day occurred. The medical director of the institution, who was involved in the decision-making but not in the treatment itself, reflected on the events.
“With today’s science, things might have been different,” she said about the way in which the nurse was discussed about breaking professional secrecy. That was an important moment for the former nurse. “I’m very happy to hear that,” he responded.
Whether the healthcare providers involved have indeed acted in a disciplinary culpable manner will only become clear on July 24. The disciplinary board will then make a decision.