Patient to Physician Confidentiality: Under All Circumstances?

Within the May 10 2013 issue of the New York Times comes the following concern from a physician:

I am a physician. Years ago, I saw a young patient with headaches, who disclosed — reluctantly — that he had committed a serious crime and that somebody else took the fall for it. I believe he was telling me the truth (his headaches soon resolved after the confession). Before his admission, I assured him that whatever he told me would not leave the room. Later, without giving specifics, I consulted our hospital lawyer, who told me that we were under no obligation to report the incident, because the patient wasn’t in danger of hurting himself or others. But the future of an innocent man hinges on two people’s consciences, my patient’s and my own. I feel like a coward, hiding behind the Hippocratic oath, doing nothing. NAME WITHHELD

Well, if you were going to give advice to this physician..what would you say? If the doctor had initially given the patient assurance of confidentiality, should that promise be kept under any circumstance that arose in further communication? What is your opinion? ..Maurice.

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