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Patient Confidentiality – Case-Based Discussion Worksheet
Name: Muhammad Abu Bakar
Roll Number: 22102
Class: 3rd Year MBBS
Date: 28/04/2025
Objective
To develop understanding of patient confidentiality through analysis of fictional clinical scenarios, enabling students to identify breaches, justify ethical decisions, and reflect on their responsibilities.
Instructions
Read the scenarios carefully. For each case, fill in the table by identifying whether confidentiality was maintained or breached, justify your answer, and reflect on what should have been done from a medical student’s perspective.
Case 1:
A 17-year-old girl has been regularly visiting her GP for counseling related to stress and anxiety due to academic pressure. Her mother, noticing frequent visits, finds a follow-up appointment slip and confronts the GP, demanding to know what is going on, insisting she has the right to know everything about her daughter’s health.
Case 1:Answer
What Should Be Done: The GP should maintain the girl’s confidentiality unless there’s a risk of serious harm.
Justification / Ethical Reasoning: At 17, she has the right to confidential care if deemed competent (Gillick competence).
Personal Reflection / Learning Point: Confidentiality must be respected even for minors if they are capable of informed decisions.
Case 2:
A doctor’s mother is admitted to the hospital. Although he is not part of the treating team, he insists on accessing her full medical records, including progress notes, lab results, and nursing charts.
Case 2:Answer
What Should Be Done: The doctor should not access his mother’s records without permission from the treating team.
Justification / Ethical Reasoning: Accessing records without clinical involvement breaches confidentiality and privacy rules.
Personal Reflection / Learning Point: Even family ties do not justify breaking patient confidentiality without proper authorization.
Case 3:
A general practitioner suspects that a child is being physically abused based on repeated injuries and the child’s behavior. The parent denies any problems and asks the doctor not to report anything further. The GP is unsure about breaching confidentiality.
Case 3:Answer
What Should Be Done: The GP should report the suspected abuse despite the parent's request.
Justification / Ethical Reasoning: Protecting the child from harm overrides confidentiality under mandatory reporting laws.
Personal Reflection / Learning Point: Patient safety, especially in vulnerable populations like children, must come before privacy.
Case 4:
A married man is diagnosed with HIV. He asks the doctor not to inform his wife and authorities about the diagnosis, insisting that it is his personal matter and he will manage things in his own time.
Case 4:Answer
What Should Be Done: The doctor should encourage the patient to inform his wife but maintain confidentiality initially.
Justification / Ethical Reasoning: Confidentiality should be preserved unless others (wife) are at significant risk of harm.
Personal Reflection / Learning Point: Handling sensitive conditions like HIV requires balancing confidentiality and duty to warn.
Case 5:
A woman visits her GP with multiple bruises and signs of physical trauma. She quietly reveals that her husband has been abusive but begs the doctor not to inform anyone, fearing for her safety if authorities get involved.
Case 5:Answer
What Should Be Done: The doctor should prioritize the woman’s safety and seek consent to involve authorities.
Justification / Ethical Reasoning: Autonomy should be respected unless there is an immediate risk to life or serious injury.
Personal Reflection / Learning Point: Confidentiality must be balanced with the need to protect patients from ongoing violence.
| Case Number | What Should Be Done | Justification / Ethical Reasoning | Personal Reflection / Learning Point |
|---|---|---|---|
| Case 1 | The GP should maintain the girl’s confidentiality unless there’s a risk of serious harm. | At 17, she has the right to confidential care if deemed competent (Gillick competence). | Confidentiality must be respected even for minors if they are capable of informed decisions. |
| Case 2 | The doctor should not access his mother’s records without permission from the treating team. | Accessing records without clinical involvement breaches confidentiality and privacy rules. | Even family ties do not justify breaking patient confidentiality without proper authorization. |
| Case 3 | The GP should report the suspected abuse despite the parent's request. | Protecting the child from harm overrides confidentiality under mandatory reporting laws. | Patient safety, especially in vulnerable populations like children, must come before privacy. |
| Case 4 | The doctor should encourage the patient to inform his wife but maintain confidentiality initially. | Confidentiality should be preserved unless others (wife) are at significant risk of harm. | Handling sensitive conditions like HIV requires balancing confidentiality and duty to warn. |
| Case 5 | The doctor should prioritize the woman’s safety and seek consent to involve authorities. | Autonomy should be respected unless there is an immediate risk to life or serious injury. | Confidentiality must be balanced with the need to protect patients from ongoing violence. |