Question

132 1/PRINCIPLES OF HEALTH CARE ETHICS CASES FOR ANALYSIS 1. Mary is in need of a kidney transplant, and her parents and siblings have been tested for compatibility. Her father is afraid of operations and knows that kidney trouble runs in the family. Before the test, Mary's father tells the doctor that he does not want anyone, especially his wife, to know that he is compatible. He explains that if the family knows they will pres- sure him into being a donor. The father turns out to be the only one who is compatible. Mary asks the doctor, "Are you sure no one in my family is compatible?" Is the father a patient and protected by confidentiality? Even if he is not a patient, is his explicit request, which was not refused, a protection of his confidentiality? If the matter is confidential, what can the physician ethically say or do to protect the secret? 2. The Smith family is in a car accident, and all five family members are hospitalized as a result. The father is critically injured, and in two days it becomes clear that he is going to die. The wife, although making good progress, is still confined to her room. When she is told of her husband's deteriorating condition, she insists that the physician tell her husband, since he is the sort of man who would want to know. The children, still in the hospital, have not seen their father and keep asking about him. The physician refuses to tell the husband of his condition. He dies a few days later Did the physician have an obligation to tell this patient that he was dying especially since this patient would want to know? Did the physician have a right to tell the wife since the patient was competent and there was no need for a surrogate? What should the children have been told when they asked about their father?

Answer 1

1)Every individual deserves the rights for maintaining confidentiality by the healthcare provider.The physician can protect the secret ethically by telling that his father is compatible but due to "age difference " donating by him to his child is a barrier in the success rate and there are chances of organ rejection. This will protect the confidentiality as well as make the patient and family realise the situation that the prognosis of both in the family bare equally important

2)Accident is an unexpected event which caused severe injury to Mr.Smith.Though the patient would want to know his condition or status as per his wife's request, the physician obliged from telling at this time because the acceptance level of the patient will be very less and may even result in any untoward incidents earlier. A surrogate is not necessary here because the patient nis in sound mindvsnd not in comatose stage.

The children should be taken for counselling to prevent Post traumatic stress syndrome and slowly made understood about the facts.