Match each clinical scenario to the most appropriate legal or ethical action regarding patient confidentiality.
- A 6-year-old boy presents with patterned bruises resembling a belt; the parents provide an inconsistent history of the injury.Mandatory reporting to child protective services or an equivalent welfare agency.
- A 28-year-old restaurant food handler is diagnosed with an active hepatitis A infection.Mandatory reporting to the local department of public health.
- A 35-year-old psychiatric patient explicitly states a credible, detailed plan to murder a specific, named coworker.Permitted or mandated disclosure to law enforcement and the intended victim.
- An adult daughter calls the clinic requesting the recent biopsy results of her competent 65-year-old father.Strict maintenance of confidentiality; no disclosure permitted without explicit patient authorization.
Answer
The correct pairings align the child abuse scenario with CPS reporting, the hepatitis A diagnosis in a food worker with public health reporting, the credible threat to a third party with law enforcement/victim notification, and the family request for a competent adult's records with the strict maintenance of confidentiality.
Medical confidentiality is a core ethical principle, but specific legal and ethical exceptions exist to protect vulnerable individuals and the broader public. Suspected child abuse, reportable infectious diseases, and credible threats to third parties are universally recognized exceptions where disclosure is either mandatory or legally permitted. Conversely, routine requests from family members regarding a competent adult do not fall under any exception and require strict adherence to privacy rules.
Step-by-Step Solution
Key Concept
Exceptions to Medical Confidentiality