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Discussion Starter · #1 ·
A 65-year-old man presents to the physician’s office with his daughter, who is a resident in internal medicine. She encouraged her father to come in because he has experienced a 4.5-kg (10-lb) weight loss in 2 months, as well as decreased appetite and occasional night sweats. She thinks his eyes appear somewhat icteric. After the physician conducts the interview, the physician and the patient’s daughter leave so the patient can undress for the examination. Once in the hallway, the daughter says to the physician in a low voice, “I am really afraid that he might have pancreatic cancer, and he would be devastated to find out. Can you please discuss his test results with me first so that we can decide what to tell him together?”
How should the physician respond?

(A) “As long as your father agrees to have me discuss his health situation with you privately, I would be happy to do that, and we can decide together what information to give your father. Remember your HIPAA (Health Insurance Portability and Accountability Act) training.”
(B) “Don’t worry, I doubt that he has pancreatic cancer.”
(C) “I am ashamed of you. An internal medicine resident should know better than to ask me that.”
(D) “I appreciate your concern, but your father has a right to full disclosure, and it would be inappropriate for me to withhold information from him. Perhaps we can explore with him what information he might like to hear and if he would like for you to be present when we discuss his examination findings and results.”
(E) “If this is really important to you, I can tell you the results before I tell your father.”
(F) “I would be happy to do that, but first we have to have a full family meeting and discuss together what would be best for your father.”
 

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Discussion Starter · #3 ·
Yes, you are correct

The correct answer is D. Patients have a right to full disclosure of their medical status, and family members cannot request that the physician
withhold information from a patient. Furthermore, without the patient's explicit permission, the physician cannot discuss the patient's health status with anyone else.
Answer A is incorrect. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 mandates complete confidentiality in patient care, although patients may allow their physicians to discuss their health situation with specified individuals. Regardless of this, however, the physician still cannot withhold information from the patient at the request of a family member.
 
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