AMA (Legal Issues) Patient Confidentiality: "Physicians have always had a duty to keep their patients' confidences. In essence, the physician's duty to maintain confidentiality means that a physician may not disclose any medical information revealed by a patient or discovered by a physician in connection with the treatment of a patient. "
American Medical Association article presents their guidelines and a description of the legal aspects of patient confidentiality and management. However, exceptions to confidentiality are noted: "Communicable diseases and gunshot and knife wounds should be reported as required by applicable statutes or ordinances. Thus, the physician's duty of confidentiality at times must give way to a stronger countervailing societal interest." But these acts which break patient confidentiality are not that ethically simple. In fact they become practical dilemmas that physicians face. Should a physician maintain confidentiality when the patient's spouse or sexual partner is at physical risk because of an HIV infection of the patient and the patient refuses to tell or when genetic testing reveals the potential for illness in other members of the family and the patient refuses to tell? With regard to gunshot, knife wounds and other findings which may have legal implications for the patient, should the treating physician extend his/her role from therapy to police work? What do you think about these questions and how would you answer them if you were the physician? Write and tell me. ..Maurice.