[1015] in Discussion of MIT-community interests
Shin article in Globe: "Parents were last to know"
daemon@ATHENA.MIT.EDU (Christopher Beland)
Wed Jan 30 22:15:46 2002
Content-Type: text/plain
Content-Transfer-Encoding: 7bit
Mime-Version: 1.0
Message-ID: <1012446536.9641.3.camel@press-your-luck>
Date: Wed, 30 Jan 2002 19:08:53 -0800
From: Christopher Beland <beland@MIT.EDU>
To: MIT-Talk@MIT.EDU
Parents were last to know
By Eileen McNamara, Globe Columnist, 1/30/2002 [page B1]
Maybe Elizabeth H. Shin was beyond saving. Maybe the MIT sophomore was
as intent on secrecy as she was on suicide.
---
But if the 19-year-old biology major was as determined to conceal her
self-destructive impulses as MIT contends, why were they so well known
on the campus? If hers was so hopeless a case of depression, why
wouldn't Shin's therapists have sought a last-ditch alliance with the
people who knew her best, her parents?
The aspiring geneticist did not want her parents to know how
despondent she was in the weeks before she set herself on fire in her
dorm room on April 10, 2000. But isn't a doctor's first obligation to
a patient's survival, not her confidentiality?
Dr. Paul R. McHugh thinks so. ''Privacy isn't everything; life is
everything,'' says the former chairman of the department of psychiatry
at Johns Hopkins School of Medicine, who was named last week to the
President's Council on Bioethics. ''We lock people up, we take their
civil liberties away if they are a danger to themselves. But we can't
call the parents? What kind of nonsense is that?''
Speaking generally because he is unfamiliar with the details of the
Shin case, McHugh says he has trouble understanding why any therapist
would not reach out to a suicidal teenager's parents. ''With a
suicidal patient, privacy concerns go out the door. You tell her, `I
need all the help I can get to save you. I insist on calling your
parents. If you don't like it you can sue me.' At least, then she'd be
alive to sue.''
Shin, of course, is not alive to sue, so her parents have. In a
wrongful death lawsuit filed this week, Cho Hyun and Kisuk Shin accuse
the Massachusetts Institute of Technology of failing to provide the
mental health care that might have saved the oldest of their three
children. Like the Scott Krueger case before it, the death of Liz
Shin could help redefine the relationship between institutions of
higher learning and the parents who entrust children to their
care. (Krueger, an MIT freshman, died of alcohol poisoning during an
initiation rite at an unsupervised fraternity party. The university
settled a lawsuit by his parents and apologized for the lax housing
and disciplinary policies that contributed to their son's death.)
In the Shin case, the standards of psychiatric practice are as much on
trial as the negligence of the university. How could a student who
expressed her suicidal intentions as loudly and as often as Shin did
over the course of a year to faculty members, on-campus therapists,
and her dorm mates have slipped through the cracks?
Given the severity of the various diagnoses she received - some
doctors suggested she had a serious borderline personality disorder -
how could MIT psychiatrists not inform Shin's family of her
deteriorating condition?
It is disingenuous to argue, as MIT has, that the so-called Buckley
Amendment, a federal law that safeguards the confidentiality of
student records, prevented the university from alerting Shin's family
to her psychiatric crisis. ''If she fell down the stairs and was
unconscious, wouldn't they call her parents?'' David DeLuca, the
attorney representing the Shins, sensibly asks.
It is worse to suggest, as MIT also has, that it is not responsible
because Shin may have come to Cambridge with the mental health issues
that spiraled into suicide. ''Oh, please,'' says McHugh. ''Students
come to school with lupus and asthma and the health services deal with
it.''
Dr. Margo Goldman of Wakefield, chairman of the confidentiality
committee of the American Psychiatric Association, says it is
important ''to start with the assumption that what a patient tells you
is kept in confidence. But when a patient is in danger of harming
herself, the therapist is obliged first to keep the patient safe.''
Shin was the 10th of 12 suicides at MIT since 1990. You might have
thought the university would have learned that lesson.
Eileen McNamara can be reached by e-mail at mcnamara@globe.com.
---------------------------------------------------------------------
Documentation on the use of the mailing lists mit-talk, all-talk,
mit-news, housing-talk, and the mit-talk Zephyr class is available at:
http://web.mit.edu/institvte/talk/
