Book contents
- Frontmatter
- Contents
- Contributors
- Acknowledgments
- Introduction
- PART ONE DEFINING MEDICAL PROFESSIONALISM
- PART TWO CASES INVOLVING MEDICAL STUDENTS
- PART THREE CASES INVOLVING PHYSICIANS
- 3 Principle of Primacy of Patient Welfare
- 4 Principle of Patient Autonomy
- 5 Principle of Social Justice
- 6 Commitment to Honesty with Patients
- 7 Commitment to Patient Confidentiality
- 8 Commitment to Improving Quality of Care
- 9 Commitment to Maintaining Trust by Managing Conflicts of Interest
- 10 Commitment to Professional Responsibilities
- APPENDIX: Cases by Specialty
- Index
- References
7 - Commitment to Patient Confidentiality
Published online by Cambridge University Press: 25 February 2010
Book contents
- Frontmatter
- Contents
- Contributors
- Acknowledgments
- Introduction
- PART ONE DEFINING MEDICAL PROFESSIONALISM
- PART TWO CASES INVOLVING MEDICAL STUDENTS
- PART THREE CASES INVOLVING PHYSICIANS
- 3 Principle of Primacy of Patient Welfare
- 4 Principle of Patient Autonomy
- 5 Principle of Social Justice
- 6 Commitment to Honesty with Patients
- 7 Commitment to Patient Confidentiality
- 8 Commitment to Improving Quality of Care
- 9 Commitment to Maintaining Trust by Managing Conflicts of Interest
- 10 Commitment to Professional Responsibilities
- APPENDIX: Cases by Specialty
- Index
- References
Summary
PATIENT CONFIDENTIALITY – INFECTIOUS DISEASE
A physician in a small community practice realizes that his hepatitis C-positive patient is dating one of his other patients who is hepatitis C negative. Upon questioning by the physician, the hepatitis C-positive patient reports that he has not told his girlfriend of this infection.
A Perspective from a General Internist
Clinical Background
Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States with approximately 1.8 percent of the population infected. HCV is transmitted parenterally by transfusion, intravenous drug use, and accidental needle stick. Sexual transmission can occur, although the risk appears to be very low (less than 3 percent in monogamous partners).
Routine testing for HCV is recommended for high-risk individuals such as persons with history of injected drug use or unexplained abnormal ALT levels, for recipients of blood products or organs before 1992, and persons on chronic hemodialysis. It is unclear if long-term monogamous sex partners of HCV-positive persons will benefit from testing. Testing should be preceded by appropriate counseling. All HCV-positive individuals should be counseled to change behaviors that increase the risk of HCV transmission.
Professionalism Considerations
The physician in this case faces a dilemma as his HCV-positive patient has not told his girlfriend about his infection. The girlfriend is also his patient and is HCV negative.
Information
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- Professionalism in MedicineA Case-Based Guide for Medical Students, pp. 273 - 308Publisher: Cambridge University PressPrint publication year: 2009
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