The urban emergency department: the issue of professional responsibility

The urban emergency department is routinely asked to manage not only medical emergencies, but also a great variety of social emergencies. This situation is caused in part by budgetary constraints which prevent other agencies from providing 24-hour coverage. In an age of instant access to computerized information, these conditions often result in ethical and legal problems of extreme complexity. A case is presented which raises the issues of confidentiality and liberty in the fiduciary relationship between doctor and patient. The concept of personal care is found to be paramount.