In general, a person is required to report criminal activity and to appear and
testify as a witness if requested by the defendant or the state. As long as the
report is made in good faith, the law protects persons who report crimes from
being sued for defamation by the person they report.
This creates a conflict of interest with a patient’s expectation that a physician
will preserve the confidences of the physician–patient relationship. This conflict
is most acute for psychiatrists: their physician–patient relationships are
critically dependent on trust, and their patients are much more likely to discuss
matters such as criminal activity with them. The general duty of a medical care
practitioner is limited to the reporting of possible future criminal activity, not to
turn in their patients for past acts that come out in during medical treatment or
The medical care practitioner’s duties are much more rigorous when dealing
with crimes related to medical care business practices.