This is what it looks like when a public relations-hyped psychiatrist turns out to be a dangerous therapist. During the PR campaign for his new book, Israeli psychiatrist Ilan Rabinovich violated his professional obligation of confidentiality vis-a-vis one of his famous patients, the late TV star Dudu Topaz: Rabinovich published the last message Topaz left him on his answering machine before he killed himself in his detention cell in August 2009. Topaz, as will be recalled, was then being held on suspicion of having planned and carried out a series of brutal attacks on his former employers at the TV station.
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Rabinovich claimed that Topaz’s children gave their consent to the publication of his desperate cry for help. But isn’t he familiar with the Patient’s Rights Act of 1996, which stipulates that the family of a patient, whether during his life or after his death, does not have the authority to permit publication of information from his medical file? Doesn’t he know that a person’s right to privacy does not expire following his death, and that only a court has the power to release a therapist from the obligation of preserving medical confidentiality after a patient’s demise?
It’s true that there are cases in which a person’s heirs may point to a legitimate interest in revealing details from the deceased’s medical file, even if the law would generally prohibit it, but the right to privacy is a “personal right,” not a “property right” that passes to the patient’s heirs upon his death. On the contrary, it’s precisely from family members that a deceased patient has the right to “protection” by his therapist, because chances are that things he said to the therapist relate to them in one way or another, or might influence their attitude toward him.
Relations with a therapist are also informed by an ethical standard that transcends patient’s rights law. It ascribes great importance to the therapist’s preservation of the confidentiality of clinical materials entrusted to him by the patient, even if the family demands their revelation.
But Rabinovich does not accept responsibility for any aspect of his treatment of Topaz, even as he continues to reap profits from the posthumous stardust. His justification for the decision to make public the message Topaz left him is his desire to prove that the entertainer’s suicide might have been prevented if only Rabinovich’s warnings had been heeded.
The doctor says he “knew” that Topaz was about to take his life, but where were his prophetic skills when his patient’s mental state began to deteriorate, and the degree of danger he posed to his surroundings was no less than the degree of the risk he constituted to himself at the end of his life?
One need not be a sorcerer to understand that Topaz’s voice has been conjured up from the doctor’s answering machine eight years after his suicide in order to serve the doctor’s selfish needs. To date, Rabinovich, who appears frequently on TV and radio, has not given the impression that he is the serious face of the discipline he hypes so persistently.
Dudu Topaz acknowledged tragically late that he’d morphed from entertainer to criminal. Alone in his cell, his psyche could not sustain the pain of the shame, the guilt and the contrition. Every therapist who is imbued with professional integrity and self-awareness would have allowed himself, too, to experience feelings of guilt and contrition in light of the tragic end of a patient like Topaz. It’s to be hoped that this was the case with Rabinovich as well. No one expects him to share with the public the inner reckoning he has undertaken as a therapist, but it is reasonable to ask him, at the very least, to stop playing with the truth, let his famous patient rest in peace, and stop exploiting him so crassly for the purpose of increasing sales of his book.
Rabinovich’s difficulty in distinguishing between his personal interest and the interest of the Other is also apparent in the use he has made of his difficulties with his own children in the media in order to drum up sympathy and evade criticism of his professional performance.
In Robert Wiene’s film “The Cabinet of Dr. Caligari,” a psychiatrist-sorcerer utilizes his hypnotic skills in order to cause one of his assistants to commit murder. The silent 1920 film vividly captured the escapist mood that prevailed in Germany after the end of World War I. Some later critics read the story of the perverse relations that existed between an authoritative and corrupt doctor of the soul and an assistant who acts under his influence as a cautionary allegory of the repressive and criminal potential that was inherent in the submissive relations between the Germans and authoritarian figures. The peak of the political and moral stupor occurred in the catastrophic elections of 1933 and in the subsequent destruction and devastation.
The media presence of the psychiatrist to the famous has long since become a horror show of authoritarianism, emotional confusion, superficiality and kitsch. Something disturbing is happening in the flourishing clinic of this Israeli Dr. Caligari. Failure to preserve a patient’s medical confidentiality can constitute a warning light of the slippery slope on which medical and psychotherapeutic ethics can be found in a profligate Israeli society that is losing its mind.
Dr. Eran Rolnik is a psychiatrist and a psychoanalyst.