Maliheh Kadivar, Zeinab Jannat Makan,
Volume 6, Issue 6 (2-2014)
Abstract
Secrecy or confidentiality has always been considered a crucial issue in the medical profession. Secrecy is a common and essential principle among patients and physicians, and is highly emphasized in professional ethical codes and guidelines.This case report is based on an actual case in Medical Ethics Grand Rounds in Tehran Children's Medical Center, with a glance at the boundaries and challenges of keeping and revealing the secrets of the patients.Case Scenario: In this report, a neonate with withdrawal symptoms was admitted to the hospital. After routine examinations by the medical team, they found the neonate’s mother was addicted and had concealed her addiction from her husband and her family. To facilitate treatment of the infant, they discussed the matter with the mother in order to get accurate information. The mother’s denial on one hand, and the need for accurate and comprehensive information necessary to begin treatment on the other caused a challenge to keeping or disclosing the mother’s secret. Here the medical team assumes responsibility to obtain the information from the mother, convince her and win her cooperation, and finally share the secret with the spouse to help their ill neonate.Although respect for patients’ confidentiality is an imperative issue for physicians and healthcare workers, it is not an unequivocal requirement. Due to logical and religious reasons and based on each specific case, it is necessary to make decisions that are more reasonable and less harmful to the patients and their families. Naturally the staff is required to keep the secrets of their patients permanently.
Seyed Saied Seyed Mortaz, Parvin Delavar, Nafiseh Zafarghandi, Mohammad Reza Yektaei, Qolamreza Moarefi, Ali Davati, Shiva Rafati, Siamak Afshin Majd, Ahia Garshasbi,
Volume 11, Issue 0 (3-2018)
Abstract
A 62-year-old man referred to the emergency department 48 hours ago with chief complaint of repeated bloody vomiting. The patient is admitted and the necessary measures are taken. Within 24 hours, he received 6 units of blood. The patient has undergone endoscopy, but endoscopic endorsement has failed to stop the bleeding. The surgeon consulted and visited the patient. He considered urgent emergency laparotomy. The patient is alert and refuses surgery. The hemodynamic status of the patient is not stable and gastrointestinal bleeding continues. These questions are posed to medical staff and hospital managers: "What is our duty”? "Should we respect the choice of the patient and witness the progress of the disease and deterioration of the patient's condition"? "Can he be discharged from the hospital on the basis of the patient's refusal to take medical treatment"? "Can we take appropriate diagnostic and therapeutic measures with the use of legal capacity and support despite patient’s opposition? "How can one regard autonomy, beneficence, and nonmaleficence at the same time, in this situation "? In this study, which is one of the problems of medical ethics, the ethical, legal, and health aspects of the presented patient are discussed.
