Patient Privacy the Ethical Dilemma Essay

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One issue which has gained in public attention in recent years, first with the outbreak of SARS and avian flu, and more recently with the spread of swine flu, is that of public health epidemic. A failure to disclose health concerns properly or to allow others to know when one is seriously ill is a way to instigate the spread of a condition. Thus, "public health has laws governing reportable illnesses such as TB, small pox, and sexually transmitted diseases. In these cases, the patient's identity is exposed in order to protect the general public." (Quan, 1) Thus, the protection of patient privacy without proper consideration of these concerns may manifest as a more serious and widespread public health crisis.

And from a legal standpoint, one of the most treacherous legal paths concerns the question of the patient's potential danger to himself or others. This is a condition which was prompted by a case in the 1970s where a young man infatuated with a woman named Tatiana Tarasoff and resentful over her rejection, entered into a serious depression. Stalking Tarasoff and seeking counseling, the young man told the therapist of his intent to kill the woman. When the authorities were notified, they determined that he was not a threat and released him, at which point he followed through on his plan. When the parents of the slain girl sued the University of California for its failure to intervene, the outcome raised a discussion over the right of physicians to disclose otherwise confidential information given by a client.

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The issue was settled to the end that where such danger may be demonstrated, it is the ethical and legal responsibility of the physician to bypass the code of confidentiality. According to the majority opinion in the 1976 case, "the ultimate question of resolving the tension between the conflicting interests of patient and potential victim is one of social policy, not professional expertise. The risk that unnecessary warnings may be given is a reasonable price to pay for the lives of possible victims that may be saved. One of the famous alliterative quotes from this case is, 'The protective privilege ends where the public peril begins.'" (Supreme Court of California, 1)

Conclusion:

The above sentiment is an appropriate point upon which to close this discussion, remarking as it does on the idea of a 'public peril' that may be invoked by an overly protective emphasis on patient privacy. In reality, though this patience is desirable and demands discretion by medical health professionals, there may also be a social good in promoting a culture in which health-consciousness and awareness superceded the current emphasis on a medical secrecy that is unhealthy to the individual, to those around him and to the broader healthcare system.

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