•What should you do?
We should do nothing as the patient has a fundamental right to privacy.
•As a health information professional – can you tell your friend?
No. The person has full control over his own medical data, and medical professionals and informaticians must ensure that all protected health information (PHI) are handled with confidential manner. The disclosure of personal data without consent can lead to serious consequences and disrupt the trust of patients to the information systems.
•Can you interfere with other people or family issues?
No. As a health information professional, we must never disclose personal health data, especially sensitive information as it will be violation of ethical standards.
•But, should your friend not know about this because she might be at risk?
Yes, she might be at risk, but a health professional must never intervene directly into patient/family matters. Instead, we may encourage the patient (with proper clinical channels) to disclose himself, if the health condition can risk his spouse. However, the final decision to disclose is up to the patient himself.
•How will you follow the fundamental principles about right to self-determination, doing good and doing no harm to others?
I will follow the fundamental principles by:
Respect the patient’s autonomy – ensuring he has the authority to make decisions about his health information and respect of patient’s dignity, privacy and rights.
Doing Good – I must stay within my professional boundaries while promoting the well-being of all parties. If I am concerned for the spouse, I can encourage proper counseling and disclosure through clinical channels, not through personal communication. If I am still not sure of what would be the best for both parties, I can seek guidance through ethical board/committee without mentioning patient’s identification.
Do no harm- Avoid any action that could lead to harm. Disclosing patient’s HIV status without consent can lead to psychological stress, social stigma and self-harm. This can have a huge effect of patient’s trust on the health system.
•Isn’t it your obligation and the right of the subject to hold the information?
Yes, it is the right of patient to hold the information, and it is my obligation to protect the right.
I am obliged to respect the patient’s ownership of their health information, ensure the confidentiality and security of PHI, avoid disclosure without consent.
