Not all physicians agreed with that practice, labeled therapeutic privilege
This principle is called therapeutic privilege, which was clearly enunciated in Nishi v.
In addressing the therapeutic privilege defense raised by the defendant, the Hawaii Supreme Court held that "the doctrine recognizes that the primary duty of a physician is to do what is best for his patient, and that a physician may withhold disclosure of information regarding any untoward consequences of a treatment where full disclosure will be detrimental to the patient's total care and best interest" (Nishi v.
Court of Appeals in the District of Columbia also articulated the therapeutic privilege exception to informed consent, in order to enable the doctor to withhold risk information if such disclosure would pose a serious threat of psychological detriment to the patient.
Although the emerging consensus is that therapeutic privilege "should be c onstrued very narrowly and applied only in the most exceptional circumstances," (16) no such privilege applies in the research context.
Furthermore, by requiring "full and frank disclosure" he set aside any appeal to therapeutic privilege as a justification for non-disclosure of information.
29) The explanation seems to lie in the history of therapeutic privilege and the expectation that more latitude is allowed in clinical situations with regard to the amount of information that must be disclosed.
This rule of disclosure has one exception, the therapeutic privilege
, in which the physician withholds information out of concern that it would harm the patient.
This is the therapeutic privilege
that can be traced back to Hippocratic writings and was firmly established by Percival in his Medical Ethics of 1803.