Confidentiality is “an obligation
or pledge of medical professionals to keep secret the personal health information
of patients unless they consent to disclosure.”
One of the conflicts we discussed concerning confidentiality was whether
the obligation to respect confidentiality is absolute, meaning it applies the same way in all cases, or Prima Facie, meaning we allow for
exceptions when other duties apply. I
thought this was a difficult topic to have a definitive answer on, since if I
was to pick one way or the other there will always be at least one really good exception
that will follow to make me unsure of my decision. Although I do believe that doctors should definitely
hold firm to their code of confidentiality, I also think that there are some special
cases in which the doctor may have a better grasp on the situation, and
therefore has a right to use his best judgment to do what is most advantageous
for the patient. However, when a patient
goes to a doctor or other medical professional for help, they are aware that
this code of confidentiality exists between them, but the doctor also has an
obligation to do what is best for the patient.
Therefore when this patient approaches the doctor seeking his
professional help, they are also allowing the doctor to take a paternalistic authority
in their lives and furthermore releasing a tiny bit of their own autonomy to
him.
The
point that I am trying to convey is that I do not think that we as spectators
can rightfully decide whether confidentiality should be accepted as absolute or
prima facie; but it is something that only a doctor or medical professional in
such a situation can decide for what would be the most advantageous thing to do
based on the concern of that specific patient.
Which could potentially therefore result in a different decision in each
and every situation, depending on the doctor, the patient, or the situation. The only downfall that may be associated with
this idea is that doctors are only human, in so far as they too are just as
flawed as every other human on earth; they make simple human errors, they make
irrational decisions based on the influence of their emotions, and they let
other people’s opinions sway their own.
Therefore, I guess this means that I think that the obligation to
respect confidentiality is Prima Facie.
Good argument. You are very right concerning the nature of how situations, circumstances vary. However there are some issues that are always absolute. One is that doctors have taken oaths - sworn. They are not omnipotent or omniscient (pointing to your comments about their humanity). When one consults a physician, they are stating some trust in that person's medical knowledge. That consultation does not infer that they (doctor) are the sole authority in any case. The informed consent really does give the patient a level of autonomy in their particular case. If information is withheld how can any patient rightly make good decisions. Once doctors have permission to override their oaths, rights of the patient to know and autonomy according to that physician's opinions/outlooks, etc. where does it stop? Prima facie, yes, this is a consideration. But only if that patient has specifically stated they do not want to be informed in this or that circumstance. Doctors ought to tell the truth to their patients.
ReplyDeleteYour argument is valid, but i really don't believe in the idea of Prima Facie. Not all situations are the same and any medical professional must act to each situation differently without bias. But I see a doctor's job is to do what's best for their patient. If that means the doctor must break his/her confidentiality oath.
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