WBR0761

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Author [[PageAuthor::Rim Halaby, M.D. [1] (Reviewed by Will Gibson)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Ethics
Sub Category SubCategory::Pulmonology, SubCategory::General Principles
Prompt [[Prompt::A 62-year-old man presents to his physician's office complaining of dry cough. Following appropriate work-up, he is diagnosed with small cell lung carcinoma and requires chemotherapy. During his first session of chemotherapy in the hospital, his oncologist visits the patient to make sure he is doing well and has no complaints. After the visit, the patient's 27 year old daughter, who is waiting outside the infusion room, asks the physician what will happen to her father. Which of the following is the most appropriate answer in this situation?]]
Answer A AnswerA::"I apologize I may not answer your question. You may discuss with your father all what you need to know."
Answer A Explanation AnswerAExp::The physician is not supposed to disclose any information about the patient's without the patient's consent.
Answer B AnswerB::"Your father will hopefully recover if he continues his chemotherapy."
Answer B Explanation AnswerBExp::This reply implies the physician is providing prognostic information and breaching patient's confidentiality.
Answer C AnswerC::"Your father cannot make it without your continuous support."
Answer C Explanation AnswerCExp::This reply implies the physician is providing prognostic information and breaching patient's confidentiality.
Answer D AnswerD::"We should not speak publicly of your father's condition. Please visit me in my office to talk to you confidentially."
Answer D Explanation AnswerDExp::The physician is not supposed to disclose any information about patient medical information. This includes public or private conversations with other individuals.
Answer E AnswerE::"Your father's condition will most likely worsen due to the side effects of chemotherapy"
Answer E Explanation AnswerEExp::The physician is not supposed to disclose any information about patient medical information.
Right Answer RightAnswer::A
Explanation [[Explanation::Patient confidentiality is very important in medicine. Physicians are not allowed to disclose any information about adult patients' medical records, their diseases, treatment plans, prognosis, or even their identities as patients to other individuals. Adults are all individuals who are 18 years of age or older. When confronted with situations where family members inquire about a patient, physicians are expected to politely refrain from giving information without the patient's consent. Alternatively, physicians may ask the family members to ask the patient what they need to know.

Educational Objective: A physician must not disclose any information about adult patients to anyone without the patient's consent.
References: First Aid 2015 page 58]]

Approved Approved::No
Keyword WBRKeyword::Ethics, WBRKeyword::Consent, WBRKeyword::HIPAA, WBRKeyword::Privacy, WBRKeyword::Patient privacy, WBRKeyword::Confidentiality, WBRKeyword::Confidential, WBRKeyword::Medical record, WBRKeyword::Small cell lung carcinoma, WBRKeyword::Cancer, WBRKeyword::Chemotherapy, WBRKeyword::Informed, WBRKeyword::Disclosure
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