Académique Documents
Professionnel Documents
Culture Documents
Confidentiality: - (crowded area). Lets step off the elevator and talk
privately
GOAL: Discuss pt in Private setting
Boundary Violations:
26yo F. asks doctor if he was married. Tells physician should consider going
out for dinner sometime. Dr. Finds patient attractive and would like to accept
the invitation. Which is most appropriate response to Pts request?
A: Decline the invitation, explain that dating the patient is ALWAYS
UNETHICAL
[Trap: politely decline the invitation and explain that it is inappropriate for
the patient to ask for a date This is a critical statementmay make the pt
feel embarrassed or ashamed]
[Trap: Decline the invitation, explaining that the Physician-Patient
Relationship must be terminated prior to dating a patient - NO, this response
might encourage the pt to end the pt-dr. relationship in hopes of dating the
physician]
Romantic Relationships between Psychiatrists and former patients
are always considered unethical.
Dr-Patient Relationship:
28yo woman. Multiple failed fertility treatments. She confides the fetus is
not her husbands Child. Her husband is also the physicians patient, and she
asks the Dr. Not to tell him about this because it will ruin everything. Which
of the following is the most Appropriate response by the physician?
A: I will not tell your husband
[TRAP: I will not inform your husband, but lets discuss ways that you could
tell him yourself. This I judgmental and coercive DR. should be neutral
with regard to patients decision and NOT FORCE her into actions which she
may be Uncomfortable]
Impaired Collegue:
Intoxicated colleague while on duty. Case: what do you do?
A: Contact the colleagues on call supervisor to report the problem
now
[Trap: Report the incident to the hospitals physician health program =.
YES if NON-Emergency situation]
[Dr is ETHICALLY AND LEGALLY obligated to report IMPAIRED
colleagues in a timely manner]
Confidentiality:****
Having dinner with colleague, a physician notices one of his patients at other
table.. Colleagues asks how you know her? Shes a family friend who was
recently diagnosed with breast cancer and have been worried about her.
Can I assume she is a patient of yours and ask how shes doing?
A: No, I cannot say whether she is my patient
[Trap: She is my patient, but I am unable to discuss her treatment due to
patient confidentiality]
GOAL: Protect patient confidentiality in all situations
[Physician should NEITHER CONFIRM nor DENY whether person is a patient]
Elder Abuse:
84yo brought in by daughter after falling and hitting her head on bathroom
sink. Physician interviews patient. Daughter interrupts and answers all
the questions while patient remains quiet. Daughter describes concerns
Error made:
Next step: Interview Pharmacy, nursing, and medical staff on the
units where this occurred
Confidentiality:
46yo Manchest pain 30minutes ago. Has hx alcohol and cocain abuse A
woman came in says she is his wife and asks about his condition. Im so
worried please tell me if my husband is okay. Action?
A: Inform the woman that the patient is stable, but that she will have
to wait until he can give permission to share any details
Goal: Protect Pt privacies.. requires Pts explicit CONSENT to share medical
information with others including family and friends.
Obtaining a sexual History: Have your sexual partners been women, men,
or both?