WBR1023

Author	[[PageAuthor::Vidit Bhargava, M.B.B.S [1] (Reviewed by Serge Korjian)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Ethics
Sub Category	SubCategory::General Principles
Prompt	[[Prompt::A patient has an absolute right to maintain all his medical information confidential. The physician is obligated to respect a patient's privacy and to withhold sharing any private medical information with other individuals, including family members, close friends, or colleagues. Which of the following conditions does not uphold this principle?]]
Answer A	AnswerA::A physician withholds information from a spouse demanding to know more about her husband's diagnosis
Answer A Explanation	AnswerAExp::This is the correct behavior in this situation. Unless the patient specifically permits sharing his medical information, it should no be shared with his wife.
Answer B	AnswerB::A physician withholds information from an employer calling to ask about the reason an employee has been absent
Answer B Explanation	AnswerBExp::This is the correct behavior in this situation. The situation demands a valid written consent from patient, which may be explained to the employer.
Answer C	AnswerC::A physician withholds information from a colleague that asks about his son who tested positive for syphilis
Answer C Explanation	AnswerCExp::This is the correct behavior in this situation. Sharing medical information with a fellow physician not personally involved in the care of the patient is not permitted by privacy laws.
Answer D	AnswerD::A physician divulges information to state police officers who call about a man suspected of rape and murder.
Answer D Explanation	AnswerDExp::Law enforcement officers require a valid court issued warrant that should be presented to the physician in order to justify disclosing confidential patient information.
Answer E	AnswerE::A physician divulges the diagnosis to the family of a patient with pertussis.
Answer E Explanation	[[AnswerEExp::Pertussis is a highly contagious respiratory infection that affects patients of all ages and may lead to severe life-threatening complications. Individuals in close contact with patients diagnosed with pertussis require post-exposure prophylaxis to prevent transmission and development of clinical disease. Physicians are allowed to divulge specific medical information when withholding it may pose a public threat.]]
Right Answer	RightAnswer::D
Explanation	[[Explanation::Confidentiality is a core principle in medical care. By upholding confidentiality and personal privacy, physicians encourage patients to seek medical care and discuss their problems more openly without fear of sharing such information. Confidentiality also circumvents any discrimination based on their medical condition. Patient's informed consent is required before the release of any medical information; nevertheless, confidentiality is not absolute. It may be revoked in cases where a patient's confidentiality poses a threat to other individuals, or the public, or in cases where the law requires it. There are certain circumstances in which a physician may disclose patient information. However, disclosure should be made in specific circumstances in a manner that minimizes harm to the patient: When law enforcement members obtain a warrant allowing them to access an individual's medical information. When a court of law requests information regarding a patient. When withholding information about a disease that may be a threat to other individuals or the public. Educational Objective: Confidentiality may be revoked in cases where a patient's confidentiality poses a threat to other individuals or the public or in cases where the law requires it. Law enforcement officers require a valid court issued warrant that should be presented to the physician in order to justify disclosing confidential patient information. References: Snyder L. American College of Physicians Ethics Manual: sixth edition. Ann Intern Med. 2012;156(1 Pt 2):73-104.]]
Approved	Approved::Yes
Keyword	WBRKeyword::Ethics, WBRKeyword::Confidentiality, WBRKeyword::Warrant, WBRKeyword::Law enforcement, WBRKeyword::Breach of confidentiality, WBRKeyword::Privacy
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