It would have been quite an extension of Miranda for the court to hold doctors must warn their patients about the possible further use of their statements. Gibson I can see it now: "If you want to die or receive inadequate treatment you have the right to remain silent, if you give up the right to remain silent, your statements to me may end up in a medical report which might be obtained by a grand jury without your knowledge . . ." Imagine what danger lurks in an expansive interpretation of 38.23.