Confidentiality: Ethical Disclosure of Medical Information Medicine in the Service of the FBI By: Shamieka Lewis Courtney Jones Loukisha Johnson
Dilemma 6 <ul><li>In the “New and Notes” section of a leading medical journal the following notice appeared. It is an exact reproduction of an FBI poster: </li></ul><ul><li>WANTED BY THE FBI </li></ul><ul><li>A Federal Grand Jury in Tucson Arizona indicted Shelby for conspiring with another individual in an act which involved the interstate transportation and unregistered possession of 120 sticks of dynamite, 30 electric blasting caps, 20 fuse caps, and50 feet of fuse. Shelby, using the name William Allen Friedman, allegedly drove from Venice, California to Tucson, Arizona, purchased the explosives and fuse, and returned to Venice, California. </li></ul><ul><li>CAUTION: SHELBY HAS BEEN KNOWN TO ASSOCIATE WITH INDIVIDUALS WHO ADVOCATE THE USE OF EXPLOSIVES AND SHE HERSELF HAS ACQUIRED EXPLOSIVES. SHE REPORTEDLY MAY HAVE ACQUIRED FIRE-ARMS AND SHOULD BE CONSIDERED DANGEROUS . </li></ul>
Shelby is known to be afflicted with a skin condition known as acne vulgaris, which has been described as acute and recurrent. The recurrent aspect of this skin condition could necessitate treatment by a health care practitioner, especially a dermatologist. Shelby is also known to frequently wear prescription eyeglasses or contact lenses, which are required for her to operate an automobile. NOTIFY THE FBI Any person having information which may assist in locating this fugitive is requested to immediately notify the nearest FBI field office, the telephone number of which appears on the first page of most local telephone directories .
Stakeholders: <ul><li>Shelby AKA “William Allen Friedman” </li></ul><ul><li>Physician </li></ul><ul><li>FBI </li></ul><ul><li>Citizens of USA </li></ul>
Important Terms: Autonomy - the right of patients to make decisions about their medical care without their healthcare provider trying to influence their decision. Confidentiality- the principle in medical ethics that the information a patient reveals to a health care provider is private and has limits on how and when it can be disclosed to a third party. Beneficence- a principle of medical ethics according to which a person should do good to others especially when one has a professional duty to do so. Non-maleficence- the ethical principle of doing no harm.
If Physician Cooperates With FBI <ul><li>Shelby AKA “William” will be apprehended. </li></ul><ul><li>Any criminals affiliated with “William” may be apprehended also. </li></ul><ul><li>Citizens of America will be safer. </li></ul><ul><li>Physician can sleep at night knowing he made the right choice. </li></ul>
If The Physician Chooses To Respect Patients Privacy <ul><li>Citizens of America can be harmed by firearms or explosives. </li></ul><ul><li>“ William” and his affiliates can form gangs around the country and us all. </li></ul>
Conclusion <ul><li>If the physician cooperates with the police it would be a breach of confidentiality. However, in this case it would be justified because the harm in maintaining confidentiality is greater that the harm of the physician cooperating with the FBI. There are certain regulations that limit the patients right to privacy. For example, if there is concern for public safety of other persons or concern for public welfare. I don’t think reporting the person to the FBI is related to medical treatment because the physician doesn’t have to disclose the medical record. I also think when someone is involved in illegal activities they forfeit their right of confidentiality. </li></ul>