UNESCO Course on
Benefit and Harm
CASE STUDY 29: INFORMATION – VIOLATION OF MEDICAL
CONFIDENTIALITY
On April 18, 2003, Ms. X got into an argument with her live-in
partner, and was stabbed with a knife in the lower right side of her
back. She was transferred to the National Hospital. The doctor in
charge examined Ms. X and found that the stab wound on the lower
right side of her back was about three centimeters long. Moreover,
her clothes were extremely bloodstained.
The doctor explained to Ms. X that her urine needed to be tested for
blood to determine whether the stab wound had punctured the
kidney but she adamantly refused to have a urine test. The doctor
finally decided to perform a procedure in which he would anesthetize
her and then sew up the wound in order to stop the bleeding. The
doctor explained the procedure to Ms. X and told her that a urethral
catheter would be inserted in her body. Ms. X received an anesthetic
injection without showing resistance.
While Ms. X was under the influence of the anesthetic, the doctor
collected a urine sample by inserting a catheter in her body.
Although the collected urine sample did not contain blood, the doctor
suspected that Ms. X was under the influence of drugs. He therefore
conducted a simple drug test, and found a positive reaction for
amphetamines.
In the meantime, Ms. X’s parents had come to visit her. The doctor
explained the extent of her injury to them, and informed them that
stimulants had been detected in her urine sample. The doctor further
explained to Ms. X’s parents that, as a national public officer, he was
obligated to notify the police of this fact. The doctor then notified a
police officer that stimulants had been detected in Ms. X’s urine
sample.
Should the doctor have disclosed information about the
presence of stimulants in Ms. X’s urine sample to her
parents and to the police officer?