Question

You are providing care to a 54-year-old male patient complaining of chest pain. The patient asks to speak to you privately. He tells you he is taking Cialis® for erectile dysfunction and his wife does not know he is taking it. He does not want his wife to find out. As you are putting the EMS bags back in the ambulance, the wife corners you and insists that you tell her what her husband said. What should you do?

A. You should tell her. As his spouse, she is legally entitled to know his medical information.
B. You should not tell her. There is no reason to humiliate your patient by disclosing his embarrassing condition.
C. You should not tell her. By law, your conversation with your patient is confidential.
D. You should tell her. He may be having an affair without her knowledge and she needs to be tested for sexually transmitted diseases.

Answer 1

You must maintain patient confidentiality and not disclose information about a patient's use of Cialis® or any other medical condition to their spouse, as required by law. The patient's privacy rights are generally prioritized over the partner's right to know, and this is protected by HIPAA.

Step-by-step explanation:

The situation you are describing involves a conflict between maintaining patient confidentiality and the spouse's request for information. According to HIPAA (Health Insurance Portability and Accountability Act), any conversation you have with your patient regarding their medical information is confidential. This includes discussions about medications like Cialis® for erectile dysfunction. Even though the spouse may have concerns, you cannot disclose any information without the patient's consent. The correct action to take in this scenario would be option C: You should not tell her. By law, your conversation with your patient is confidential.

Regarding the broader ethical questions, the patient's right to privacy typically takes precedence over the partner's right to know, unless there is a substantial risk of harm or a legal requirement to report certain diseases. However, when minors are involved, laws may differ and often take into account the minor's age and the nature of the medical situation. Physicians must navigate these cases with professional care, respecting the privacy of the adolescent while considering the parents' concerns and the well-being of all parties involved.