Ethical Dilemma Essay Research Paper A patient

Ethical Dilemma Essay, Research Paper

A patient comes into the hospital to see his results from an AIDS test: his results are positive. The patient nervously confesses to the doctor that he s been cheating on his wife. His wife and the doctor are friends, they ve been friends throughout school, but later drifted apart. However, they still maintain a good friendship, occasionally get together call each other for advice, or simply to share their problems since they ve been friends for so long. The doctor never actually met her friend s husband in person but after looking at his file she notices his last name and phone number are the same as her dear friend s. The doctor then informs the client of her friendship with his wife.

Should she tell the wife because he could pass this incurable disease to her? Or should she keep this information confidential because of her duty as a doctor?

This situation creates an ethical dilemma because no matter what decision the doctor takes it will oppose a belief. In this scenario the patient is the client seeking the service of a doctor. Therefore, the doctor must take a course of action based on mutual agreement that will not violate their relationship. As a professional, her primary duty is to serve the client, which in this scenario is the patient with AIDS. In order to better serve the client she will persuade and convince him to tell his wife in effort to maintain his autonomy and confidentiality. She will let him know that she must report this to government health authorities, and other health professional working with him. These health professionals need to be forewarned, so that they can take extra precautions. AIDS is now a reportable communicable disease in every state Physicians and hospitals must report every case of AIDS- with the patients name to government public health authorities (Pozar 384).

The doctor is not removing the patient s autonomy, however by giving him advice (persuading him) she is not respecting his autonomy to the fullest extent. In Clinical Ethics it is stated:

Patient preferences are ethically significant because they make explicit value of personal autonomy that is deeply rooted in ethics of our culture. Moral philosophers emphasize the principle of autonomy, the moral right to choose and follow one s own path of life and action. Respect for autonomy is the moral attitude that disposes one to refrain from interference with others autonomous beliefs and actions in the pursuit of their goals. Constraint of a person s free choices and actions seriously infringe on another s rights and welfare. The recognition of patient preferences respects the value of personal autonomy in medical care. In practice, however, many forces obstruct limit the expression and appreciation of patient preferences. These forces such as compromised competence of the patient, disparity between practitioner s knowledge and that of the patient, the psychodynamics of the patient-physician relationship, the stress of illness-often make difficult the realization of respect for the autonomy of the patient (Jonsen, Siegler, Winslade 50).

In other words, based on the value of autonomy the doctor should respect the patient s preferences. If the doctor were to tell her patient s wife she would completely remove the patient s autonomy since the patient would no longer be able to choose or have any influence on the reaction his wife takes. This could lead to consequences such as divorce, which would change his path of life. By influencing the patient to tell his wife the doctor is not removing the patient s autonomy, however she is reducing it by convincing the patient to tell his wife. The patient was planning on not saying anything, so if he tells his wife this action will not be his choice of action but one that the doctor influenced him to do.

According to Jonsen, Siegler and Winslade:

A patient s right to privacy and confidentiality has one of the highest priorities in our legal system. Statutes and court decisions proclaim the duty to provide, maintain, and enforce a patient s right to privacy and confidentiality, and also the perils of failing to do so. The Supreme Court has recognized it as a constitutional right. No longer is privacy and confidentiality merely a moral, ethical, professional obligation; it is a legal duty. The duty of the medical confidentiality is an ancient one. The Hippocratic oath states: what I see or hear in or outside the course of treatment, I will keep to myself, holding such things shameful to speak about (Jonsen, Siegler, and Winslade 166).

In essence, professional ethics require that the doctor maintain patient confidentiality; that is one of the highest values in the heath care profession. In the event that the doctor divulges this information, respective malpractice insurance policies might not cover the institution for a breach of confidentiality if the patient sued. The doctor s livelihood and professional reputation be at stake. She would be viewed as unprofessional for not upholding her duties she would develop a bad reputation that would reflect on the institution as well. After weighing the factors the realizes that if she breaks the confidentiality she could be dismissed from her job immediately and be liable for charges laid, and fines upon conviction.

Disregarding this duty of confidentiality also affects medical care in the