Ms. L

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Ms. L is a 28-year-old woman admitted to General Hospital to deliver her first child.  In the past she has been treated for pyro-mania and schizophrenia (paranoid type), and since the age of 18 she has spend a total of 5 and a half years in a state mental hospital. She has also been arrested for arson on three occasions.  Each arrest led to a court referral for psychiatric care.

            Mrs. D, the social worker on the Ob-Gyn service at General Hospital, is familiar with Ms. L’s psychiatric history and arrest record because she was formerly employed by the community mental health center where Ms. L had been a patient.  During a pre-delivery conversation with Ms. L about her plans, Mrs. D discovers that Ms. L. has no current residence and spent the previous year drifting from shelter to shelter.  Ms. L. informs Mrs. D that after her baby’s birth she is planning to move in temporarily with a local Rabbi and his family, who occasionally share their home with people in dire straits.

            Mrs. D immediately begins to wonder about warning the Rabbi about the danger to him, his wife, and young children.  As a member of Rabbi P.’s congregation, Mrs. D is aware that, on occasion, he opens his home to transients.  She is very concerned about the welfare of Rabbi P’s family, given Ms. L’s documented history of arson.  The next day, Mrs. D asks Ms. L. for permission to talk with Rabbi P. about her housing needs and about the difficulties she has experienced over the years.  Ms. L refused permission for such disclosures.

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-->Crigger, Bette-Jane. Cases in Bioethics : Selections from the Hastings Center Report. 3rd ed. New York: St. Martin's Press, 1998.