A senior New Zealand psychiatrist who was the responsible clinician for a Kiwi man found hanging upside down in a drum of water in a Samoan prison has been granted permanent secrecy.
The doctor treated mental health patient Hans Dalton before he travelled with his family to Samoa for a holiday in December 2012.
But while there Dalton's family were confronted with Cyclone Evan, the worst tropical cyclone to hit the Pacific nation in 20 years.
During the natural disaster, Dalton suffered a mental health episode and his family sought help for the 38-year-old from local authorities as he became increasingly agitated.
But instead of being taken to a hospital he was moved to Tafa'igata prison because of the lack of facilities for mentally-ill patients.
The next morning, Dalton's bruised body was found upside down in a drum of water inside a cell.
After several years of fighting for answers to shed light on how Dalton died, Dalton's family met with Deputy Prime Minister Winston Peters last year before a Coroner's inquest was held in December.
During the inquest, Dalton's doctor's decision to allow him to travel to Samoa, the management of his care, and his medication regime were all questioned.
The Dalton family lawyer, Olinda Woodruffe, also raised allegations of failings on the doctor's part.
Last week Coroner Peter Ryan released his findings and said while the cause of Dalton's death was ruled to be drowning he was unable to determine how he died - citing several possible scenarios.
Yesterday, he also granted Dalton's doctor permanent name suppression.
But he did so without the psychiatrist's application for a gag order being served on media organisations which covered the inquest and had opposed such an order.
Coroner Ryan said in his findings there wasn't any "significant deficiency in the care" provided to Dalton by the doctor but Woodruffe nonetheless "has been vocal in her criticism".
"I accept that if the [doctor's] identity is allowed to be published, then he may well be subject to further criticism by the family in media reports. This is likely to impact adversely on his privacy and reputational rights," the Coroner said in his suppression ruling.
The psychiatrist had argued publication would adversely affect patient care, especially if patients had access to media articles about the inquest which included the doctor's name.
He also said there would be a negative impact on the efficient operation of the mental health system.
"The [doctor] considers that any publicity of his name is likely to increase his patients' anxiety, resistance to treatment and non-compliance with medication," Coroner Ryan's ruling reads.
"He points to a specific example where he appeared as a witness in a murder trial, and the publicity around that case caused one patient to question whether the service took responsibility for their discharge of patients."
Coroner Ryan said the doctor also had "legitimate, justifiable and actionable interests" in protecting his privacy and reputation and there is the need to maintain "an effective and efficient mental health system".
While accepting there was a public interest to publish the identity of a psychiatrist involved with a patient who dies, and for the public to know about any deficiencies in care, he did not consider there was a significant public interest in Dalton's case.
"My finding does not identify any significant deficiency in the care provided to Mr Dalton by the [doctor]. Therefore, there is no need to identify the applicant for the purposes of protecting the public," he said.
"Of paramount concern to me is the effect of identifying the applicant on his patients, particularly the potential damage to the therapeutic trust-based relationship necessary for effective mental health treatment.
"There is minimal public interest benefit in identifying the [doctor]. But there is significant potential reputational damage to the [doctor]."
Samoan police initially declared Dalton's death a suicide but later charged an inmate with murder. However, the conviction was overturned because of a lack of evidence.
Coroner Ryan said a homicide was "still a possibility and cannot be discounted".
Other possibilities, he said, could be that Dalton suffered a heart attack and fell into the drum, suicide, or that Dalton was trying to cope with the heat and thirst and accidentally drowned.
The inquest was hampered by several unsuccessful efforts by New Zealand police, the Ministry of Foreign Affairs and Trade, Interpol, and the Coroner's office to gather evidence from the Samoan Government about Dalton's death.
The Dalton family had also earlier requested that Coroner Ryan recuse himself on grounds of alleged bias, the Herald reported in June.
The application for recusal was dismissed by Coroner Ryan.