- This topic has 14 replies, 15 voices, and was last updated 10 months, 3 weeks ago by Noi Yar.
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2023-10-07 at 9:45 am #42188SaranathKeymaster
Please watch the VDO for topic discussion.
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2023-10-09 at 2:15 pm #42269Weerapat PipithruengkraiParticipant
These are my opinions and solutions to this scenario.
What should you do?
In this situation, the most moral thing to do is to maintain patient confidentiality and not tell anyone without their consent.As a health information professional – can you tell your friend?
No, I cannot tell my friend. As a health information professional, I need to obey laws and ethical standards. This means I cannot disclose a patient’s medical information to anyone without their consent, even if that person is a friend.Can you interfere with other people or family issue?
No, I cannot interfere in other personal or family matters. My responsibility is to keep patient information secret.But, should your friend not know about this because she might be at risk?
Yes, my friend should know about this. However, I cannot tell her without her husband’s consent.How will you follow the fundamental principles about right to self-determination, doing good and doing no harm to others?
The best way to help her in this situation is to talk to my friend’s husband about the importance of disclosure and offer him support.Isn’t it your obligation and the right of the subject to hold the information?
Yes, it is my obligation to protect patient information. Patient have the right to control their information and I need to follow this rule.
However, as I mentioned above, there are solutions if there is a risk to my friend’s health or safety. -
2023-10-12 at 6:42 pm #42343Nichcha SubdeeParticipant
A health information professional must have an awareness of the code of ethics for this position. The solutions to each question in this scenario are provided below:
– What should you do?
Maintaining the patient’s confidentiality is essential. A health information professional cannot violate patient confidentiality by sharing a patient’s health information with others without the patient’s consent.– As a health information professional, can you tell your friend?
Definitely not. Without the patient’s consent, you cannot disclose patients’ health information to anyone, even if you know them personally.– Can you interfere with other people’s or family issues?
No, you cannot interfere with other family matters.– But, should your friend not know about this because she might be at risk?
Even if you have good intentions to inform her about the risk, it is still inappropriate to disclose the patient’s information without their consent.– How will you follow the fundamental principles about the right to self-determination, doing good, and doing no harm to others?
Ultimately, it is up to the patient to decide whether to disclose their health information to others or not. This is the patient’s right to self-determination. Additionally, maintaining the confidentiality of a patient’s health information and avoiding any actions that could harm the patient or others is what a health information professional should do.– Isn’t it your obligation and the right of the subject to hold the information?
Patients have the right to keep their health information confidential. So, the answer is yes, a health information professional has the primary duty to maintain and protect a patient’s health information as private. This is the ethical obligation that health information professionals should uphold. -
2023-10-13 at 10:21 pm #42351Soe HtikeParticipant
As a health information professional, I have a number of ethical obligations competing with each other to consider in this situation. This is a difficult scenario, and there is no easy answer.
What should I do?
As a health information professional, I should respect the privacy and confidentiality of patient information. I should not disclose any information about a patient’s health status without their explicit consent. However, it is important to note that I am not a counselor or a therapist. My primary role is to provide patients with information about their health status and to help them make informed decisions about their care. I should not try to counsel my friend or interfere with her relationship with her husband. I’d encourage the patient to speak with his healthcare provider about the importance of informing close contacts (especially his wife) regarding the condition.
As a health information professional, can I tell my friend?
As a health information professional, I must protect the confidentiality of patient information. Patients have the right to make decisions about their health care, including who has access to their medical information. However, I also have to act in the best interests of my patients and avoid causing harm to them. In this situation, I may need to balance the two ethical obligations of confidentiality and beneficence. If I decide to tell my friend about her husband’s HIV infection, it is important to do so in a sensitive and supportive way. I should be prepared to answer her questions and provide her with information about HIV and how to protect herself. Although there is a serious ethical dilemma, I don’t have the skills or experience to handle that kind of situation, and I think it is not my duty to disclose such kind of sensitive information, regardless of my close relationship with the patient and my friend. So, I cannot tell my friend about her husband’s health status without his consent.
Can I interfere with other people or family issues?
No, it is not appropriate for me to interfere in other people’s personal or family issues, especially when it involves sensitive and confidential health information. My role as a health information professional is to provide patients with information about their health status and to help them make informed decisions about their care.
But should my friend not know about this because she might be at risk?
My friend should know about her husband’s HIV infection because she may be at risk. While I might be concerned about my friend’s health, it is not my place to disclose this information. If I am concerned, I might consider encouraging her husband to share this information with her. Another thing I consider is to disclose this information to my supervisor to discuss the situation and get their input. They can help me to weigh the different ethical factors involved and to make a decision that is in the best interests of both people.
How will I follow the fundamental principles about the right to self-determination, doing good and doing no harm to others?
I can follow these principles by respecting the patient’s right to self-determination and privacy and by acting in a way that does not cause harm. This means not disclosing the patient’s health status without their consent. By respecting patient autonomy, I uphold the right to self-determination. I am also following the principles of doing good by supporting the patient in making informed decisions about their health. By maintaining patient confidentiality, I am adhering to the principle of doing no harm to others.
Isn’t it my obligation and the right of the subject to hold the information?
Yes, as a health information professional, it is my obligation, and the patient has the right to control who has access to their medical information. I also need to respect his right to self-determination. -
2023-10-13 at 10:22 pm #42352Teeraboon LertwanichwattanaParticipant
In this situation, if I were her friend and discovered that her husband had HIV infection without her knowledge, I would honor the patient’s right to privacy and confidentiality. Regardless of my personal relationship with the patient, I would never disclose any patient’s identity or personal data without their consent. Even if I knew the husband, I would still maintain confidentiality, respecting the patient’s choice to disclose their health status.
I would refrain from interfering in their relationship or family matters because it’s not within my jurisdiction. Despite my friend potentially being at risk, I cannot reveal the patient’s personal information without their explicit permission.
Adhering to ethical principles, it’s essential to recognize patients’ rights to protect their personal information. Everyone has a responsibility to promote the well-being of others and prevent harm. If I were the doctor treating her husband, I would respect the principles of autonomy and beneficence by encouraging the patient to share his condition with his wife. Upholding the principle of non-maleficence, I would advise him to involve his wife in the healthcare process, ensuring her safety and well-being. The conversation with the patient would focus on the advantages of early treatment and the significance of involving family members.
However, if I were in the role of an informatician, I would maintain my position that personal data cannot be disclosed, regardless of the circumstances. Regarding the last question, my primary duty would always be to safeguard and protect a patient’s health information as private. This ethical obligation is fundamental and must be upheld by all health information professionals.
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2023-10-14 at 1:45 am #42357Sirithep PlParticipant
What should you do?
As a health information professional – can you tell your friend?
As I was one of the healthcare personnel and health information professionals, I should hold on to the principle of ethics. In this given situation, I should have accountability and respect to the privacy rights of the patient. Although this information is related to my close person, the information of her husband should be protected and confidential. So, I do not tell my friend about this information.Can you interfere with other people or family issue?
But, should your friend not know about this because she might be at risk?
According to the former statement, this information is private information, I cannot interfere with his/her life and family. Though she is in risk, I can only talk to her as the usual conversation such as her own and her husband health, advice her for check up her health if she seems to be high risk.How will you follow the fundamental principles about the right to self-determination, doing good and doing no harm to others?
Isn’t it your obligation and the right of the subject to hold the information?
Following these principles, I respect the confidentiality and privacy of the patient information for self-determination. I cannot disclose the information without consent. I can only provide advice or information to related persons for decision making in doing good and no harm to others. -
2023-10-14 at 10:58 pm #42367Pyae Thu TunParticipant
From the point of view of a health information professional, I should respect the confidentiality of a client’s health information. I have no right to disclose such sensitive information to my friend as there will be surely many consequences and social problems which will be difficult to handle.
We cannot interfere with other people or family issues. But by considering my friend’s health risk, I may try to discuss with the patient whether there is a possibility of disclosure the result by the patient himself. But it may need the help of a certain counselor who is expert in communicating and handling such kind of case. Knowing how to manage getting infected with HIV and the importance of informing his sexual partners will encourage him for further disclosure. Or there will be some way we could promote the health awareness and testing promotion to my friend directly anonymously by securing the patient information.
The decision of patient whether he will disclose or not will be the right of him that I need to follow as the fundamental principle. It should be self-determination and I must keep the confidentiality and try not to do anything that could harm him or my friend.
It’s my obligation and the patient have full right to control keeping their health information confidential.
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2023-10-16 at 8:24 pm #42421Suppasit SrisaengParticipant
What should you do?
I should keep the information confidential and not disclose it to anyone, including my friend. I have a professional obligation to maintain patient privacy.Can you tell your friend?
No, I can’t. Doing so would violate laws and ethical standards concerning patient confidentiality.Can you interfere with other people or family issues?
No, it’s not your place to interfere. Medical confidentiality takes precedence.Should your friend not know about this because she might be at risk?
While it’s concerning, it’s up to the patient and his healthcare providers to inform at-risk individuals, not me.How will you follow the fundamental principles about right to self-determination, doing good and doing no harm?
By respecting the patient’s right to privacy, I’m adhering to these principles. The healthcare provider should be responsible for “doing good” by informing at-risk individuals and “doing no harm” by not breaching confidentiality.Isn’t it your obligation and the right of the subject to hold the information?
Yes, I must keep the information confidential, and the patient has the right to control who has access to his medical records.In summary, it’s a tough emotional situation, but the ethical and legal guidelines are clear: maintain confidentiality.
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2023-10-17 at 11:19 am #42428PhyoParticipant
If I were a health information professional, maintaining medical records and noticing a close friend’s husband’s HIV status, I would not interfere with my friend’s family matters by using confidential information of hospital data. It is obviously in breach of confidentiality of private data which a health information professional has to uphold. It will have a negative impact on the patient’s family and social life if it isn’t managed well the situation and I am not also certain about my friend’s status at this stage.
All patients have the right to self-determination and should be treated with equality and justice. Health information professional has to follow the principle of information privacy for users. The patient could visit the hospital due to a reason of healthcare management and services. It is the obligation of clinicians and healthcare workers to deliver to appropriate services and information to patients and family members.
As long as I believe in the healthcare services and system of the hospital, I am doing good and doing no harm to others by maintaining confidential patient information while upholding the principle of autonomy and integrity. However, if I feel that the delivery of healthcare services or health system is not right or I have doubt that it could solve the situation of my friend’s risk, I should discuss, inform, or report to my supervisor/respective authority to take appropriate steps and actions. -
2023-10-17 at 8:45 pm #42442Thitikan PohpoachParticipant
May I propose a different perspective?
Theoretically, as our classmates perfectly illustrated the scenario, I should maintain the patient’s confidentiality and not disclose of HIV diagnosis to the patient’s partner. It is difficult to forecast how the patient’s partner will respond, or how their lives may change. Moreover, the lack of trust in healthcare providers may lead to the reluctance to seek HIV treatment and counseling. Therefore, it should be my obligation to protect patient information and the patients are granted autonomy in that they retain control over who has access to know the status of their health.
However, due to the possible psychological and medical benefits for the partner, as well as public health concerns (that is, the possibility of transmission to sexual partners), I think the wife should know her husband’s HIV serostatus (even though she is not my best friend). Should we have a law to protect healthy people from having sexually transmitted infections (STIs)?
I found the publication stated that STIs are the exceptions to confidentiality due to their danger to patients or others. Moreover, the sooner the partner knows, the faster they can access proper prevention or treatment.
In the United States, many states and some cities have partner-notification laws—meaning that, if you test positive for HIV, you (or your healthcare provider) may be legally obligated to tell your sex partner. In some states, if you are HIV-positive and don’t tell your partner(s), you can be charged with a crime.
Olejarczyk JP, Young M. Patient Rights and Ethics. [Updated 2022 Nov 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538279/
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2023-10-17 at 9:25 pm #42445Teerawat PholyiamParticipant
As per above scenario, here are specific answers to below questions:
What should you do?
As a health information professional, my main responsibility is to maintain patient confidentiality and adhere to ethical and legal standards. I should not disclose the patient’s HIV status to anyone, including my friend, without the patient’s consent.As a health information professional, can you tell your friend?
No, I cannot disclose the patient’s HIV status to my friend without the patient’s explicit consent. Doing this may breach patient confidentiality and violate ethical and legal standards.Can you interfere with other people or family issues?
I think that this is not my role as a health information professional to interfere in personal family matters or relationships as per my main duty is to protect patient confidentiality and secure health information management.But, should your friend not know about this because she might be at risk?
I must respect the patient’s confidentiality. Encourage the patient to discuss his diagnosis with a healthcare provider and seek professional guidance on how to disclose this information to my friend. The decision to disclose the HIV status should ultimately be made by the patient.How will you follow the fundamental principles about the right to self-determination, doing good, and doing no harm to others?
I think that I should follow the fundamental principles by respecting the patient’s right to self-determination in making decisions about his health information. Inform him to take steps that would promote his own well-being and the well-being of others, such as seeking medical advice and considering disclosing his status to his partner.Isn’t it your obligation and the right of the subject to hold the information?
Yes, it is both my professional obligation and the patient’s right to maintain their medical information. All patients have a right to privacy and confidentiality.In summary, my role as a health information professional is to maintain patient confidentiality in accordance with legal and ethical guidelines and I should not breach confidentiality by sharing this information with others without the patient’s consent.
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2023-10-17 at 11:53 pm #42449Myat Htoo LinnParticipant
This is quite difficult to be the complete consideration for the ethical dilemma, my opinion in this scenario will be as below;
What should you do?
As a health information professional, can you tell your friend?
Can you interfere with other people’s or family issues?In the aspect of health information professionals, this is sure I will try to stick to the fundamental ethical principles of not violating patient confidentiality and privacy. I cannot interfere with other people’s or family matters and will not disclose the information without the patient’s consent and fulfilling the integrity. I also think the health informatician is not in a position to communicate the information with the patient or families except to manage the EHRs of the patient.
But, should your friend not know about this because she might be at risk?
How will you follow the fundamental principles about the right to self-determination, doing good, and doing no harm to others?This is in dilemma position. I know that it is inappropriate to present the patient’s information without consent and this relates to the patient’s right to self-determination. I will keep confidentiality, follow the duty of integrity, and prevent causing harm to other persons as a non-maleficence principle. On the other hand, as the duties of a human, I will approach the respective healthcare providers or counselor that the hospital/national was authorized to prevent harm to the patient and other people. I think this was also following the principle of beneficence to advance the good of others.
I support Pohpoach’s discussion as such kind of case should be legally obligated to tell the sex partner in case of HIV test positive or that can be a crime.Isn’t it your obligation and the right of the subject to hold the information?
I do not deny that a health information professional has the ethical duty to uphold patient’s privacy and confidentiality. -
2023-10-18 at 7:24 pm #42460Panyada CholsakhonParticipant
If I am a health information professional in this situation:
What should I do?
It’s really challenging to maintain both professional and personal relationship. In this case, I have to prioritise my professional duty. I will not disclose any of my patient’s sensitive information to anyone even she is my best friend, unless I have his consent to do so. Considering the consequences as risks that she might recieve, my classmate, Thitikan’s point of view is interesting, many thanks for sharing. I just know about this and I think we should consider also in this perspective as his partner’s life is also matter.Can you interfere with other people or family issue?
I will respect the autonomy and decision-making of my best friend’s husband. Although I know his information, I wil not interfere with the family issue, it is the duty of his doctor who order this the test for him will tell the truth to him and advise about the treatment and how to prevent the transmission of disease to his love one.How will you follow the fundamental principles about right to self-determination, doing good and doing no harm to others?
As a professional, I will do no harm and doing good by not spreading his HIV status and respect his privacy, also support him if he ask for any advices.Isn’t it your obligation and the right of the subject to hold the information?
Yes, follow the principle of patient confidentiality is what health informatics professionals, must do. -
2023-10-18 at 11:33 pm #42465Ching To ChungParticipant
This is a very difficult but interesting dilemma.
What should you do?
I would be emotionally tempted to tell, but as a professional I must surpress my personal instinct and protect my patient’s privacy at all costs. It is my professional ethics and obligation to safeguard the privacy of my patients. Therefore, I would not tell my friend and I would pretend that I don’t know the person in the EMR.Can you tell your friend?
I cannot. Having HIV is one of the most sensitive patient information. Disclosing it would violate my professional code of ethics and national data protection law. I may be put on trial from both criminal law and civil law persepectives and I will 100% definitely lose my job.Can you interfere with other people or family issues?
In general, all healthcare workers should stick to their roles. For example, if a son makes medical decision for his father as a medical proxy, a doctor should respect whatever decisions he makes instead of commenting anything about what he “thinks” the son should do. For the same reason, as someone who handles EMR, it is our role to process the information, not to leak it or to gossip what others have when we get this information. We need to have the highest respect for people’s agency and autonomy, and it is unprofessional to interfere with others as if the patients are our friends.Should your friend not know about this because she might be at risk?
My friend should know about this and it is certainly worrying that she doesn’t know about this. However, it is the husband’s moral obligation to tell his wife, and it is my moral obligation to protect patient’s privacy. The fault and responsibility therefore lie with the husband, not me.How will you follow the fundamental principles about right to self-determination, doing good and doing no harm?
By not disclosing it to my friend, I am essentially honoring the principles about right to self-determination, as I am allowing the husband to choose to tell his wife or not. I will not consider this as “doing harm”, as non-disclosure would not be a form of harm. If my friend ended up contracting HIV, the responsibility lies with the husband, and it is the husband who does harm.Isn’t it your obligation and the right of the subject to hold the information?
Yes, it is my obligation as a professional to uphold patient privacy at all times -
2023-10-19 at 4:56 pm #42476Noi YarParticipant
As a public health information professional, I definitely can’t disclose my friend’s husband HIV status to my friend without his consent. The husband has the right to maintain confidentiality of his health status. On my friend side, whether she should know her husband HIV status depends on moral and legal obligations. As her husband legal sexual partner, her husband is morally obligated to let his spouse know of his status as it can not only affect her health but also their future family planning. The husband’s doctor or the medical center where he did HIV testing or getting treatment should also be responsible to give him counseling about HIV and getting his sexual partners tested for HIV too. However , final decision to let his wife and partners know of his HIV status still lies in the husband’s hand. We medical professionals and public health professionals cannot disclose the information without his consent. If there is any legal obligation to disclose status to spouses and I am certain that my friend did not know of her husband HIV status, I should contact medical center or doctor responsible for the husband’s HIV testing and treatment to inform my concern regarding my friend health and that she is in blind about her husband HIV status. It should be their responsibility to let her know. And I shouldn’t be telling my friend directly as a public health professional who is neither involved in treatment and care of the husband and my friend, since it will be breaching confidentiality and privacy of the patient.
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