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The uninformed spouse: Balancing confidentiality and other professional obligations

Supriya Subramani

DOI: 10.20529/IJME.2019.046


I use the case study presented by Bawaskar (1), which I refer to as the “The Case of the Uninformed Spouse”, to illustrate an ethical conflict between medical confidentiality and the duty to protect and inform an involved third party, who in this case is the patient’s spouse. The central question raised by Bawaskar based on this case is, ‘Is it the physician’s professional obligation to counsel the patient against marriage?’ In this commentary, I will attempt to answer this question while also engaging with the ethical conflict in this case and what issues may arise if the physician had indeed considered revealing information to the patient’s partner against the wishes of the patient. I engage on the concept of “harm” to discuss the moral scope of the duty to warn an involved third party and when it is justified to breach confidentiality of the patient. Based on the ethical analysis, I conclude that, in this case and in analogous cases, healthcare professionals should not breach the confidentiality of patients and should uphold it as the basis for trust within the doctor-patient relationship. Further, I state that it is part of their professional obligation to advise and provide psychosocial care through counselling to ensure comprehensive care.

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