Sorry my post was so confusing. Thanks for taking a shot at it anyway. I haven’t seen or heard from you in a long time. Nice to know you’re still around.

I didn’t mean to imply, nor did anyone else (I think), that confidentiality protected the doctor from the consequences of criminal law. But the doctor’s duty of confidentiality toward the patient does affect his choice. As you point out, the doctor certainly could have gone to the cop, but he can’t tell the cop where the drugs came from without revealing things his patient would rather not be revealed. Thus, to my way of thinking, as long is he doesn’t have a clear legal obligation to take the matter to the police, the duty of confidentiality should prevail, and therefore he did the right thing.

(Full disclosure: As a libertarian, even if he had a clear legal obligation to take the matter to the police, I think he did the right thing by not doing so.)

Much like if you commit a crime, if you innocently come into possession of contraband, which is pretty close to committing a crime, proper legal advice is to shut up.

I think that short circuits a lot of the scenarios you are drawing.

As for the bullshit in here about “obstructing justice,” I don’t know who these idiots are, but that’s the stupidest thing I’ve ever heard a lawyer say. SCOTUS just decided the fish case a few months ago, so we should all be up on destruction of evidence law at the federal level. State level is usually not as intense. In either case, your doctor scenario is just silly. He has no reason to believe the guy is being investigated for a crime, he has maybe some reason to be concerned about the envelope. Getting rid of it was his best option. This has nothing, frankly, to do with confidentiality. Confidentiality would not have protected the doctor in the slightest if the cop caught them. That’s a complete misunderstanding of how confidentiality works.

Now, could he also have said “fuck that!” not taken the envelope and called the cop into the room? Sure. But I tend to think that the consequences of that decision are such that most people would prefer not to do it. You get first to deal with the police, then possibly go to trial and likely get accused of being the true owner of the envelope, you have clients who, like you, don’t understand confidentiality and don’t trust you now, and other people in your own profession wondering about you. Why put up with all of that when you can quietly dispose of it and let the universe decide whether bob the executive is one day going down for his drug habit?