WBR0761: Difference between revisions

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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}} (Reviewed by Will Gibson)
|QuestionAuthor={{Rim}} (Reviewed by Will Gibson and {{YD}})
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Ethics
|MainCategory=Ethics
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|MainCategory=Ethics
|MainCategory=Ethics
|SubCategory=Pulmonology, General Principles
|SubCategory=Pulmonology, General Principles
|Prompt=A 62-year-old man presents to his physician's office complaining of dry cough. Following appropriate work-up, he is diagnosed with small cell lung carcinoma and requires chemotherapy. During his first session of chemotherapy in the hospital, his oncologist visits the patient to make sure he is doing well and has no complaints. After the visit, the patient's 27 year old daughter, who is waiting outside the infusion room, asks the physician what will happen to her father. Which of the following is the most appropriate answer in this situation?
|Prompt=A 62-year-old man presents to his physician's office complaining of dry cough. Following appropriate work-up, he is diagnosed with small cell lung carcinoma. During his first chemotherapy session in the hospital, his oncologist visits the patient to make sure he asymptomatic and has no complaints. Following the visit, the patient's 27-year-old daughter, who has been waiting outside the infusion room, asks the physician what will happen to her father. Which of the following is the most appropriate answer in this situation?
|Explanation=Patient confidentiality is very important in medicine. Physicians are not allowed to disclose any information about adult patients' medical records, their diseases, treatment plans, prognosis, or even their identities as patients to other individuals. Adults are all individuals who are 18 years of age or older. When confronted with situations where family members inquire about a patient, physicians are expected to politely refrain from giving information without the patient's consent. Alternatively, physicians may ask the family members to speak directly with the patient to allow the patient full discretion in what he/she discloses.
|Explanation=Patient confidentiality is very important, and physicians are not allowed to disclose any information about adult patients' medical records, their diseases, treatment plans, prognosis, or even their identities as patients to other individuals. Adults are all individuals who are of 18 years of age or older. When confronted with situations where family members inquire about a patient, physicians should politely refrain from giving information without the patient's consent. Alternatively, physicians may ask the family members to speak directly with the patient to allow the patient full discretion in what he/she discloses.
|AnswerA="I apologize, but I cannot I discuss your father's medical issues. You can discuss these things directly with your father."
|AnswerA="I apologize, but I cannot discuss your father's medical issues. You may discuss these matters directly with your father."
|AnswerAExp=The physician is legally and ethically barred from disclosing information about the patient's medical issues without the patient's consent.
|AnswerAExp=The physician is legally and ethically barred from disclosing information about the patient's medical issues with other individuals without the patient's consent.
|AnswerB="Your father will hopefully recover if he continues his chemotherapy."
|AnswerB="Your father will hopefully recover if he continues his chemotherapy."
|AnswerBExp=This reply implies the physician is providing prognostic information by suggesting a recovery is probable with treatment. The reply is problematic from two standpoints: 1. It may be providing false hope and 2. It breaches the patient's confidentiality by discussing the treatment he is receiving and his implied prognosis.
|AnswerBExp=The physician is providing prognostic information by suggesting a recovery is probable with treatment. The reply is problematic from two standpoints: First, it may be provide false hope; and second, it breaches the patient's confidentiality by discussing the treatment he is receiving and his implied prognosis.
|AnswerC="Your father cannot make it without your continuous support."
|AnswerC="Your father cannot make it without your continuous support."
|AnswerCExp=This reply implies the physician is providing prognostic information and breaching patient's confidentiality.
|AnswerCExp=This reply implies the physician is providing prognostic information and breaching patient's confidentiality.
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|AnswerDExp=The physician is not supposed to disclose any information about patient medical information. This includes public or private conversations with other individuals.
|AnswerDExp=The physician is not supposed to disclose any information about patient medical information. This includes public or private conversations with other individuals.
|AnswerE="Your father's condition will most likely worsen due to the side effects of chemotherapy"
|AnswerE="Your father's condition will most likely worsen due to the side effects of chemotherapy"
|AnswerEExp=The physician is not supposed to disclose any information about patient medical information.
|AnswerEExp=The physician is not supposed to disclose any information that pertain to patient medical information.
|EducationalObjectives=A physician must not disclose any information about adult patients to anyone without the patient's consent.
|EducationalObjectives=A physician must not disclose any information about adult patients to anyone without the patient's consent.
|References=First Aid 2015 page 58
|References=First Aid 2014 page 59
|RightAnswer=A
|RightAnswer=A
|WBRKeyword=Ethics, Consent, HIPAA, Privacy, Patient privacy, Confidentiality, Confidential, Medical record, Small cell lung carcinoma, Cancer, Chemotherapy, Informed, Disclosure,
|WBRKeyword=Ethics, Consent, HIPAA, Privacy, Patient privacy, Confidentiality, Confidential, Medical record, Small cell lung carcinoma, Cancer, Chemotherapy, Informed, Disclosure,
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 23:50, 6 March 2015
Author [[PageAuthor::Rim Halaby, M.D. [1] (Reviewed by Will Gibson and Yazan Daaboul, M.D.)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Ethics
Sub Category SubCategory::Pulmonology, SubCategory::General Principles
Prompt [[Prompt::A 62-year-old man presents to his physician's office complaining of dry cough. Following appropriate work-up, he is diagnosed with small cell lung carcinoma. During his first chemotherapy session in the hospital, his oncologist visits the patient to make sure he asymptomatic and has no complaints. Following the visit, the patient's 27-year-old daughter, who has been waiting outside the infusion room, asks the physician what will happen to her father. Which of the following is the most appropriate answer in this situation?]]
Answer A AnswerA::"I apologize, but I cannot discuss your father's medical issues. You may discuss these matters directly with your father."
Answer A Explanation AnswerAExp::The physician is legally and ethically barred from disclosing information about the patient's medical issues with other individuals without the patient's consent.
Answer B AnswerB::"Your father will hopefully recover if he continues his chemotherapy."
Answer B Explanation [[AnswerBExp::The physician is providing prognostic information by suggesting a recovery is probable with treatment. The reply is problematic from two standpoints: First, it may be provide false hope; and second, it breaches the patient's confidentiality by discussing the treatment he is receiving and his implied prognosis.]]
Answer C AnswerC::"Your father cannot make it without your continuous support."
Answer C Explanation AnswerCExp::This reply implies the physician is providing prognostic information and breaching patient's confidentiality.
Answer D AnswerD::"We should not speak publicly of your father's condition. Please visit me in my office to talk to you confidentially."
Answer D Explanation AnswerDExp::The physician is not supposed to disclose any information about patient medical information. This includes public or private conversations with other individuals.
Answer E AnswerE::"Your father's condition will most likely worsen due to the side effects of chemotherapy"
Answer E Explanation AnswerEExp::The physician is not supposed to disclose any information that pertain to patient medical information.
Right Answer RightAnswer::A
Explanation [[Explanation::Patient confidentiality is very important, and physicians are not allowed to disclose any information about adult patients' medical records, their diseases, treatment plans, prognosis, or even their identities as patients to other individuals. Adults are all individuals who are of 18 years of age or older. When confronted with situations where family members inquire about a patient, physicians should politely refrain from giving information without the patient's consent. Alternatively, physicians may ask the family members to speak directly with the patient to allow the patient full discretion in what he/she discloses.

Educational Objective: A physician must not disclose any information about adult patients to anyone without the patient's consent.
References: First Aid 2014 page 59]]

Approved Approved::Yes
Keyword WBRKeyword::Ethics, WBRKeyword::Consent, WBRKeyword::HIPAA, WBRKeyword::Privacy, WBRKeyword::Patient privacy, WBRKeyword::Confidentiality, WBRKeyword::Confidential, WBRKeyword::Medical record, WBRKeyword::Small cell lung carcinoma, WBRKeyword::Cancer, WBRKeyword::Chemotherapy, WBRKeyword::Informed, WBRKeyword::Disclosure
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