tag:blogger.com,1999:blog-21166579.post114937554026673768..comments2024-02-19T08:12:53.815-05:00Comments on The Right Thing: SOUND OFF: BEST INTENTIONSJeffrey L. Seglinhttp://www.blogger.com/profile/15648051034425906705noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-21166579.post-1150387125473060542006-06-15T11:58:00.000-04:002006-06-15T11:58:00.000-04:00This situation does not present a simple, narrowl...This situation does not present a simple, narrowly-defined question of doctor-patient confidentiality, though that is a major aspect.<BR/><BR/>If the physicians have a professional relationship with both patients, there is a conflict of interest which needs to be addressed. Part of a doctor-patient relationship is the duty for Full and Informed Consent, though whether this applies to the social implications of the decision as well the medical ones could be argued. <BR/><BR/>If the relationship is only with the recipient, then it seems the recipient has ensnared the physician in complicity with her lie. However, exploration of why she mentioned this fact at all is necessary - was she seeking support for a decision she believed was wrong or in someway expressing ambivalence? In addition, the social support that will be needed following the transplant needs to be considered. Who will care for the patients during their recovery (which will be at home, not in the hospital)? Implications of the effects of severe emotional distress upon health are considerations in addition to the technical aspects of the transplant.<BR/><BR/>In either case, to tell or not to tell are not the only courses of action. Most hospitals have an ethics committee who can be called upon to assist the physician in considering the ethical implications of situations. They might also assist the patient in wrestling with her decision. The 'what' may remain the same, but the 'when' and 'how' have ethical considerations as well.<BR/><BR/>Bottom line - maybe the decision is the correct one. But, this is not just about the physician. Without a broader consideration of the ethical questions and implications, the process leading to that decision is severely flawed.Anonymousnoreply@blogger.com