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Breach patient confidentiality, as this patient's care should be discussed with the daughter as she is his primary caregiver
2%
2/116
Breach patient confidentiality, as this patient is a potential victim of elder abuse and that is always reportable
84%
98/116
Do not break patient confidentiality, as this would potentially worsen the situtation
4%
5/116
Do not break patient confidentiality, as elder abuse reporting is not mandatory
0%
0/116
See the patient back in 2 weeks and assess whether the patient's condition has improved, as his condition is not severe
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The patient in this vignette is most likely the victim of elder abuse, which is one example of when patient confidentiality must be breached and the condition reported. A physician has an ethical responsibility to his or her patients to respect and protect their confidentiality in nearly every situation. The following cases are exceptions to this rule: (1) the patient expresses intentions to harm his/her self or another; (2) suspicion of child or elder abuse; (3) signs of a violent assault crime (e.g. gunshot or stab wounds); and (4) diagnosis of a reportable communicable disease. McCunney outlines the need to preserve patient confidentiality, as described in the codes of conduct from the American Medical Association, the American College of Occupational and Environmental Medicine, as well as relevant parts of the Americans with Disabilities Act of 1970. These resources can help physicians make informed decisions about patient medical information. Polito et al. describe ethical considerations, specifically in terms of internet use and electronic protected health information. There are laws at both the federal and state level to safeguard patient confidentiality. Importantly, health professionals are accountable for maintaining privacy for the patient, and must take steps to insure that electronic records are secure. Incorrect Answers: Answer 1: While his confidentiality should be breached, the patient's primary caregiver may be the suspected abuser and would not be an appropriate person to notify of suspected abuse. Answer 3 &4: Confidentiality should be breached in potential elder abuse. Answer 5: Given your concern for your patient's well-being, this is not an appropriate plan of action
2.8
(6)
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