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  #1  
Old 02-04-2012
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Medicolegal and Ethics Patient Confidentiality Issues

Well just came up a question which says a migrant worker with tuberculosis comes to a doctor and seeks medical help and also urges the doctor not to report it to the authority either his employer or the health department or the immigration department bcoz he thinks either of this will end his stay in the states.what shud the doctor do under the circumstances??well as far as the options were concerned the doctor will treat the patient was common in all but what varied was doctor shud not tell 1.immigration department 2.the health authority and medical check his fellow worker too3.to the employer4.dont tell the anyone and do as the patient wishes. and 5.dont treat the patient and inform everyone...DONT KNOW WHICH IS RIGHT.the answer said not to tell anyone and treat the patient.
another point is that in UWORLD got a qs where a american football player with infectious mononucleosis had a similar problem where he dont want the coach to know it and want to play the final match.the answer was given as TO TELL THE COACH AS WELL AS RESTRAIN HIM FROM PLAYING THE MATCH.
i still dont get the difference...please can anyone help me out.This thing seems most tricky to me.the STDS,communicable disease cases where the patient urges doc to keep mum.pls can anyone help me.THANKING you.
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Old 02-05-2012
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According to ethical and legal issues:
Rule=17:confidentialy is absolute:
-physician cant tell anyone anything about their pts without the pts permission.
-physician must strive to ensure that others cant access pt.information
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Old 02-05-2012
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Quote:
Originally Posted by avash.nrs View Post
a american football player with infectious mononucleosis had a similar problem where he dont want the coach to know it and want to play the final match.the answer was given as TO TELL THE COACH AS WELL AS RESTRAIN HIM FROM PLAYING THE MATCH.
i still dont get the difference...please can anyone help me out.This thing seems most tricky to me.the STDS,communicable disease cases where the patient urges doc to keep mum.pls can anyone help me.THANKING you.
Acording to ethical and legal issue
Rule=17:confidentiality is absolute:

5) If patient is threat to self or other,PHYSICIAN must BREAK the Confidentiality:
a) Duty to warn and Duty to protect
b) infectious disease should generaly be treated as threat,but be careful here issue is usualy geting the pt. to work with you to tell the person who is at risk.
c) in case of an STD issue is not realy whether to inform a sexual partner,but how they should be told.best advice:have a pt.and partner come to your office
d) succide,homocide,abuse are obvious threats
e) a specific threat to a specific person

BS KAPLAN NOTES: page no.210 and 2010 edition

Last edited by riya rai; 02-05-2012 at 03:38 AM.
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Old 02-05-2012
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the first question -what is the resource ,i doubt the answer ,as the answer should be 2.

do not trust any resource other than uworld .there r mistakes in others.

its a Reportable ds and the fellow workers should be checked too.
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Old 02-05-2012
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Quote:
Originally Posted by avash.nrs View Post
Well just came up a question which says a migrant worker with tuberculosis comes to a doctor and seeks medical help and also urges the doctor not to report it to the authority either his employer or the health department or the immigration department bcoz he thinks either of this will end his stay in the states.what shud the doctor do under the circumstances??well as far as the options were concerned the doctor will treat the patient was common in all but what varied was doctor shud not tell 1.immigration department 2.the health authority and medical check his fellow worker too3.to the employer4.dont tell the anyone and do as the patient wishes. and 5.dont treat the patient and inform everyone...DONT KNOW WHICH IS RIGHT.the answer said not to tell anyone and treat the patient.
another point is that in UWORLD got a qs where a american football player with infectious mononucleosis had a similar problem where he dont want the coach to know it and want to play the final match.the answer was given as TO TELL THE COACH AS WELL AS RESTRAIN HIM FROM PLAYING THE MATCH.
i still dont get the difference...please can anyone help me out.This thing seems most tricky to me.the STDS,communicable disease cases where the patient urges doc to keep mum.pls can anyone help me.THANKING you.

Did you get the TB question from Medical ethics book (if so can you tell me the question number). I rmr seeing it somewhere but can't recall where I saw it now.
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Old 02-06-2012
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THANKS a lot..and yup i am just going with UWORLD now..think its better to stick to reliable source only.THANKS a lot
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Old 02-06-2012
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Quote:
Originally Posted by suka View Post
Did you get the TB question from Medical ethics book (if so can you tell me the question number). I rmr seeing it somewhere but can't recall where I saw it now.
NO not in the ethics book.it was a qs in NBME 12 of 2010...saw the answer that i downloaded with it and it gave the seemingly 'wrong' answer.Thanks for the citation and also clarifying my doubt and no doubt the advise to stick to UWORLD only.really imprudent of me to believe every source.THE exam heat i will blame though
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Quote:
Originally Posted by avash.nrs View Post
NO not in the ethics book.it was a qs in NBME 12 of 2010...saw the answer that i downloaded with it and it gave the seemingly 'wrong' answer.Thanks for the citation and also clarifying my doubt and no doubt the advise to stick to UWORLD only.really imprudent of me to believe every source.THE exam heat i will blame though
Alright!
If I come across the question again i will let you know
Good luck!
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