Medical confidentiality and disclosure of paternity.
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The requirements of consent to medical treatment, including the legal capacity of minors, psychotic patients, and prisoners to give binding consent to medical intervention, have increasingly presented a confused and anxious problem. A series of legal decisions of a binding or persuasive nature are analysed and five "rules", outlining the extent of the duty to advise and the degree of disclosure demanded by law, are advanced.
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The Appellate Division recently overturned a Supreme Court judgement concerning the disclosure of a patient's HIV status by his general practitioner to another general practitioner and a dentist. This article examines the content of both judgements with particular reference to its implication for the medical profession, and considers the arguments that may be raised for and against disclosure of a patient's HIV seropositivity.
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This article critically examines the nature, scope, role and function as well as the pros and cons of disclosure documents as a means of procuring a patient's informed consent to proposed medical intervention. The conclusion reached is that, although the disadvantages of disclosure documents outnumber and outweigh their benefits, they should not be denied a role and function. Disclosure documents may be useful instruments for furnishing the basic information that a prudent patient would require to come to a decision whether to undergo or refuse the proposed medical intervention, but individual disclosure tailored to fit the actual circumstances of the particular patient can only be achieved by means of a disclosure conversation between doctor and patient. Hence, disclosure documents may serve as a supplement to but not as a substitute for a disclosure conversation.
Blatant examples of breeches of confidentiality are less common in comparison to the daily indiscretions that occur by members of the health care team or support staff. Yet such breeches of confidentiality are rarely identified as ethical or legal problems and therefore remain unaddressed. To uphold their moral and legal obligation to protect private information, nurses must examine the nature of their obligations and devise strategies to create and maintain a culture that holds health care professionals accountable for their actions.
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Should Recipients who have received Blood from a person who developed Creutzfeldt-Jakob disease be notified, even though there is no proof the disease will be transmitted? Does notification simply cause unnecessary anxiety? Two recipients explained their polar-opposite positions during a recent Health Canada conference.
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