one more ethical question

[Anonymous]

A patient had cancer. He told the doctor not to tell his wife that he had cancer. When the wife asked the doctor of her husband condition should the doctor tell the truth or should she listen to her patient and not to tell the wife?

[Anonymous]

A patient had cancer. He told the doctor not to tell his wife that he had cancer. When the wife asked the doctor of her husband condition should the doctor tell the truth or should she listens to her patient and not to tell the wife?

He should tell the wife. It is his duty.

[Dia]

The doctor has an obligation to maintain patient confidentiality; the husband is the doctor's patient, not the wife, and if the husband's wishes are that his medical records remain private, then the doctor must honor that request. Just my two-cents :)

[asadxyz]

More properly I should say " she " is patient 's wife not his own ( doctor"s) wife that doctor is obliged and enforced to tell each and every thing.

Note :- Every husband is like a scared rat before his wife

[Trinity]

The doctor has an obligation to maintain patient confidentiality; the husband is the doctor's patient, not the wife, and if the husband's wishes are that his medical records remain private, then the doctor must honor that request. Just my two-cents :)

I agree with Dia 110%. Patient confidentiality applies to everything except reportable diseases given out by the CDC. If the patient doesn’t want his wife to know, you can’t tell her. He's your patient. If you do, there will be a lawsuit and you will be kicked out of the US.
:twisted:

[mjl1717]

I agree with Dia and Trinity 1000%, in fact confidentiality rules have gotten stricter in the past few months. The doctor must respect his patients wishes! (Your not even suppose to have husband and wife in the same interview or examining room!)

[Anonymous]

Would the answer change if the doctor is also his wife?

[Anonymous]

Yes sir/ma'am, if the doctor tells the wife, it is considered a breech of confidentiality, and the patient can sue the doctor. You wouldn't want that, now, would you?

[anu]

I agree with you folks but will Dia or anybody answer me? What will you do IF PATIENT HAS AIDS?? Will you then tell his wife? And what about the lower lavel staff in the hospital who have no access to patient's chart (records). What about other patients who share rooms with him? On this topic I personally feel US is messed-up big time. I have worked in hospitals for years and I have come accross this situation many many times specially in psych wards it is very bad.

Anu : :cry:

[moveon]

Hi, anu, AIDS is one of the reportabel diseases.

For the question above, I agree that patient's wish should be respected and be the first place.

There are clear rules in the hospital to protect the stuff and I think all the people working in the hospital should be very serious to follow these them. And you are right, people working in hospital are facing more risk factors.

Good luck.

[Dia]

In this case, there is a protocol of ethically responsible actions for the physician. If it is not an anonymous AIDS screening, then the doctor should counsel the patient not to endanger the lives of other parties. If after counseling, the patient is not persuaded, the doctor may notify the authorities, and if/when the authorities fail to act upon your information, only then can you go to the wife and inform her of her possible infection.

In this exception, it is ethical to violate patient confidentiality because there is an overriding principle of beneficence--although the wife is not your patient, she is an individual who we can assume has a high probability of engaging in unprotected sexual intercourse with her husband, and considering the near epidemic proportions AIDS infection was approaching at the turn of the century, physicians have a moral obligation to the community to do whatever is in their power to slow if not stop spread of AIDS.

[Dia]

Just to make sure we're on the same page: we know that if a patient gives blood, even if he did not request it, the blood can be tested for HIV/AIDS, and if positive, the "upper level staff" will be informed so that proper precautions can be taken during the patient's treatment.

I'm going to have to disagree with the above two posters :( I don't think that lower level staff and other hospital patients should have access to that information. If you trust that your doctor and the nursing staff are competent, then there will not be any problem with having an AIDS patient in the hospital. In addition, recent scientific advances have made it possible to treat doctors/nurses/lower level staff that have been exposed to a low viral load of HIV/AIDS. It's called post-exposure prophylaxis (PEP) and consists of a watered down version of the AZT and 3TC cocktails (sorry if this is old information to you).