I believe that Brian should inform his partner of his HIV status. While I understand that Brian is scared to be rejected, it is not fair to this partner to be put at risk continuously by Brian due to his fear. If Brian's partner does indeed contract HIV Brian will only feel a sense of responsibility and shame, and his partner could still choose to leave him. I am once again very torn on what the doctor should do in this case. While it is against HIPPA to disclose any patient information, the Dr. probably feels like it is his duty to protect Brian's partner, as looking out for the safety of others is part of our medicinal practice. I think the Dr. should keep talking to Brian and keep displaying the overwhelming evidence that unprotected sex is not only risky for Brian's partner, but also for Brian. If Brian contracted an STD or other type of infection from his partner, Brian's own life could be shortened due to his compromised immune system. Maybe if Brian hears the danger he is putting himself in, he will reconsider his thoughts on the matter, even if this a very selfish way to decide, it is still better than the decision he had before.
Health professionals definitely have a duty to warn as in the case presented that can override the obligation to maintain patient confidentiality. If Dr. A cannot get Brian P to disclose his HIV positive status to the person he’s having unprotected sex with then Dr. A may have to break confidentiality in order to go through the process of making sure that person gets informed because by not telling his partner Brian P. is putting George’s life at risk because he could infect him with HIV.
I believe a doctor’s first allegiance is to their patient and to keep everything confidential. In this case, I think that Dr. A should strongly try to get Brian to tell George of his disease, HIV, and the risks of having unsafe sex with it. If Brian still refuses to do so I think Dr. A should then tell Brian he can not treat him anymore unless he is to tell George of everything. Dr. A should explain that it is important to not only just have honesty with your doctor, but that you need to have honesty with your partner or you may have larger consequences than rejection.
As Camille points out, unsafe sex is also a bad decision for Brian because he is putting himself at risk for STDs which could cause severe health issues because of his compromised immune system. It seems to me that as long as Dr. A feels that he has exhausted all of the options to get Brian to tell his partner about his diagnoses, including warning Brian that he has a duty as a doctor to tell George about the risk Brian is putting him in and that is Brian does not disclose this information, he will have to tell George himself, then it is the doctors duty to tell George. Brian should also be made to consider the fact that George will likely stay with him after his diagnoses is revealed and George was not infected, but if George does become infected, George will likely leave him because of the deception and the fact that Brian knowingly put him at risk. Overall, in my opinion, health care professionals have the duty to protect the health of others when their health is in serious danger and they can do something to prevent this danger.
Doctors have a duty to warn and sometimes it can override their obligation to maintain patient confidentiality. Dr. A in this case took the right measures of telling Brian how to manage the problem. That Brian should let his partner know about his HIV status and that they need to use protection. This is the most uncomfortable situation due to Brian's defiance and ignorance. Even though Dr. A and Brian have built the trust between them and its making the psychotherapy successful, still he should ask him to come with his partner to the therapy so that he may share with them about risks of having unprotected sex and the STD diseases that can be transmitted sexually. This would help out since Brian is afraid to initiate this conversation with his partner. Even though the confidentiality would have been breached indirectly, Dr. A would have helped protect the third party. Dr. a would also advice Brian and his partner to go together for HIV testing and even if one of them was infected, still they can be together if they truly loved one another.
This is a very hard case. I believe that the doctor first should try their hardest to get the patient to tell the person at risk. If the patient seems to be totally opposed to the idea then the doctor should proceed to warn the patient even if it breaks the patient's confidentiality. Maybe an alternative to the doctor just going and telling Brian P's partner would be to have them both in his office. Dr A could ask Brian P to bring in his partner and they could all talk about it together. Understandibly his partner will probably be upset but it might go better if they have a professional there. Dr. A shoud bring the idea up to Brian about bringing his partner in together and see what he thinks.
Although I understand the importance of doctor-patient confidentiality, there are times when a doctor should override this privilege. Dr. A should do everything in his power to convince Brian to tell George the truth himself, including options that others suggested like having them get tested together and making Brian understand the danger he is placing George in. If Brian does not tell George, I believe that Dr. A should intervene, because an innocent man's life is being placed in danger.
Breaching confidentiality should only be done in situations where a person is in serious danger of hurting himself or others. If Brian refuses to tell George, his willingness to place George in harm's way would qualify this situation as one such exception.
I agree with what Kimberly said about the importance of doctor-patient confidentiality. I believe that the doctor should try in everyway possible to get Brian to tell George about him being HIV positive. If Brian refuses, I don't the doctor should necessarily stop treating Brian but should let him know that he disagrees with him not disclosing his status, especially if Brian is having unprotected sex, which may lead to transferring of an STD. If this were to happen, I feel the doctor should let Brians partner know about his status.
Like Melissa said, I think the doctor has an obligation that overrides confidentiality. The partner needs to know and has a right to know. As Marion said, the doctor should at least exhaust all other possibilities to get Brian to tell his partner on his own. If not, the doctor needs to let him know. The doctor could also have Brian's partner come in and have a talk with both of them. No matter what he does, Brian's partner needs to be notified.
I agree with Jenna that the doctor should try his or her best to persuade Brian into doing the right thing and informing his parter. The doctor should push all possible outcomes of HIV, and well as informing him that if 10 years down the road Gary finds out his has been infected with HIV he will most likely leave Brian regardless. If this still does not work I think the doctor has every right to override patient confidentiality in protecting the harming of another being. It is correct that this could be considered in a way unintentional murder because HIV has the potential to be a very deadly disease
If Dr. A wants to keep his medical licenses I am afraid he has to keep silent. His best bet is too urge Brian to tell George about his status. If Dr. A should also bring up the fact that if he does infect his new partner with HIV without his knowledge, that said partner can press charges and then the fact that Brian is HIV+ will be public knowledge and will only add to his feeling of social rejection and insecurity about his attractiveness. If Brian doesn't tell George now he could further ruin both of their lives. This is just a testament about how important it is to watch out for yourself. If you choose to have sex, hopefully not unsafe sex, you talk it over with your partner and get screenings if necessary. If George was concerned about his health and the health of his partner, he would ask for screenings.
I’m pretty sure that, in this case, that the doctor must not breech confidentiality. Not only does the oath protect Brian, IF the doctor did go and warn his partner and the partner rejected and broke up with Brian, that might further Brian’s depression and he might wind up committing suicide, or some harmful act of self-mutilation, so therefore no good would come out of the doctor exposing Brian. The believe that the only time someone should “breech” confidentiality is when the healthcare team is coming together to work on the appropriate plan of care for the patient. Dr. A should realize that even if he does say something to George, the doctor (I think) will lose his license, the doctor loses Brian’s trust, and potentially causes harm to Brian, and Brian spreads the word that the doctor squealed and nobody in the community will trust him.
Dr. A should keep confidentiality with his pt so he does not lose everything he has worked for for his career. But Dr.A should keep urging Brian to tell his partner that he is HIV+ but he also needs to add the fact that serious repercussions can arise if he doesnt tell him, things such as passing on to him partner which could ruin his life and possibly lead to serious harm if he gets it and doesnt even know he was at risk. The doctor also needs to tell him that not telling him could result in a worse rejection compared the rejection he MIGHT get from his partner. Just like Christy said if the partner gets HIV then he could not only reject Brian but make sure it is known by many that he had HIV.
I do not think Dr.A should override his confidentiality with his patient. This is Brian P's decision to tell his partner about being HIV positive. All Dr.A should do is encourage Brian to share this information with his partners. It is ultimately Brian P's decision to let his partners know. Dr.A is supposed to listen and suggest ideas to Brian. He can only advise and encourage but never over step the patient-doctor boundaries.
A patient-doctor relationship is very important and can be very hard to build when dealing with someone that has an illness such as depression. Dr. A has done a well job with Brian, but he needs to continue to push the fact that Brian needs to tell George of his status. If this is the first time that Brian told Dr. A that he is having unprotected sex with George, then I do not think that Dr. A needs to find George and tell him right away. I would suggest Dr. A to keep explaining to Brian the consequences of unsafe sex and maybe as stated above have the two of them get tested together. Getting tested together will allow them to both find out at the same time their status and it could be a better way for George to find out about Brian rather than Brian having to come up with a way to discuss a hard topic. However, if a couple is having sex, they should comfortable enough to talk about things that can help them stay healthy and protected. If Brian continues to see Dr. A and tell him about his unprotected sex, then yes, Dr. A should tell George what is going on. But, then there is the issue of how would Dr. A get ahold of George with out Brian knowing right away or finding out. Doctors should not brief confidentiality unless their pt is harming themselves or others. Brian could sooner or later infect George with HIV putting George in a bad situation. So, as stated earlier Dr. A should tell George if Brian doesn't after talking to Dr. A.
I think health professionals do have a duty to warn depending on the situation. If the patient threatned to kill someone and mentioned it seveal times then it is their duty but with HIV I think it depends on if another person is in danger as in this case. Brian mentions several times about the unprotected sex and Dr. A has tried several times explaining to Brian the risks of it. I see where Brian is coming from with the rejection but he can't put others at risk because of that fear. As brittany stated if a couple is having sex then they should be comfortable enough to discuss these issues but that is not always the case. In this case I think Dr. A should tell George about Brian's status.
I basically think that a doctor only has the right to break confidentiality only if someone else's life is at risk or is threaten. In this case, I believe George's life is at risk because he has a chance of catching HIV. Even though there is a new combination of drug therapies to manage the HIV, the virus is still putting his life at risk if he catches it from Brian. Before Dr. A breaks patient confidentiality, I think he should keep on strongly encouraging Brian to tell George about his HIV status. Also, if he keeps explaining how easy it is for George to catch HIV from Brian since they are having unprotected sex, then maybe that will get into Brian's head that he should tell George. If Brian continues to say that he doesn't want to tell, then that is when Dr. A should break confidentiality and tell George for the sake of his health.
I believe that Brian should tell his partner George that he is infected with HIV. It is not only a danger to George, but also Brian to have unprotected sex. Geroge could contract the HIV from Brian, or Brian could be put in danger by contracting another disease, due to his compromised immune system. I also believe that Dr. A should do his or her best efforts to persuade Brian in changing his decision to keep his status a secret, and also his decision to have unprotected sex. Hopefully, once Brian knows that his decisions may affect his own health, he may change his mind. I still think it would be a risky decision for Dr. A to go behind Brian's back, given that they have a trusted relationship built. Brian is supposed to be able to confide in his doctor, and breaking this confidentiality would be damaging to that relationship. However, if the confidentiality rule is not broken, the consequences may be worse.
I think that Brian should tell his partner and if not the Dr. should keep trying to encourage him to do so because if may affect him. I know that people don't always want to tell someone something because they will feel rejected by them. So if Brian does not tell his partner, George, then the doctor has the right to contact George because Brian has HIV. So George's life is at risk for HIV since they are having unprotected sex which can transport the virus. The Doctor needs to encourage him and tell him how easy it would be to catch the virus. The doctor needs to tell him all the risk possible and if Brian doesnt say anything then the doctor should break the patient confidentiality
I agree with the majority, Brian should tell his partner. The Dr on the other hand should not break confidentiality. He can strongly encourage Brian to tell his partner, and hopefully with further therapy Brian will tell his partner. Now as far as the concern for are there times to break confidentiality, the answer is no. There are ways around breaking confidentiality. For example if someone says they are going to kill them then they can contain him perposing the threat without breaking confidentiality.
Clearly, I think Brian should tell his partner. Brian has a false notion of HIV and he needs to realize that safe sex and honesty is the best way to go. I do not think Dr. A should breach confidentiality, however. I think he should continue to educate Brian about HIV and protected sex and hopefully get Brian to tell his partner. I think the only time a Dr should breach confidentiality is when there is a valid threat against another person. In this case, I don't think Brian wanted to harm his partner in any way.
I feel that as healthcare professionals we all have a hard decision to make when it comes to telling family, friends, or lovers about HIV statuses. I feel that it is better to convince the patient to tell who ever he/she needs to tell, rather than telling yourself. HIV is a very serious and dangerous disease and can not be kept a secret from people who could contract it. It does not mean that healthcare providers should take the initiative to tell people. I think that Dr.A should talk to Brian more and ask him to stop having unprotected sex until Dr.A and him can come to an agreement on what to do about George. It could also be beneficial to Brian to teach him on HIV since he has misconceptions about the disease and transmission.
I believe that Brian should inform his partner of his HIV status. While I understand that Brian is scared to be rejected, it is not fair to this partner to be put at risk continuously by Brian due to his fear. If Brian's partner does indeed contract HIV Brian will only feel a sense of responsibility and shame, and his partner could still choose to leave him. I am once again very torn on what the doctor should do in this case. While it is against HIPPA to disclose any patient information, the Dr. probably feels like it is his duty to protect Brian's partner, as looking out for the safety of others is part of our medicinal practice. I think the Dr. should keep talking to Brian and keep displaying the overwhelming evidence that unprotected sex is not only risky for Brian's partner, but also for Brian. If Brian contracted an STD or other type of infection from his partner, Brian's own life could be shortened due to his compromised immune system. Maybe if Brian hears the danger he is putting himself in, he will reconsider his thoughts on the matter, even if this a very selfish way to decide, it is still better than the decision he had before.
ReplyDeleteHealth professionals definitely have a duty to warn as in the case presented that can override the obligation to maintain patient confidentiality. If Dr. A cannot get Brian P to disclose his HIV positive status to the person he’s having unprotected sex with then Dr. A may have to break confidentiality in order to go through the process of making sure that person gets informed because by not telling his partner Brian P. is putting George’s life at risk because he could infect him with HIV.
ReplyDeleteI believe a doctor’s first allegiance is to their patient and to keep everything confidential. In this case, I think that Dr. A should strongly try to get Brian to tell George of his disease, HIV, and the risks of having unsafe sex with it. If Brian still refuses to do so I think Dr. A should then tell Brian he can not treat him anymore unless he is to tell George of everything. Dr. A should explain that it is important to not only just have honesty with your doctor, but that you need to have honesty with your partner or you may have larger consequences than rejection.
ReplyDeleteAs Camille points out, unsafe sex is also a bad decision for Brian because he is putting himself at risk for STDs which could cause severe health issues because of his compromised immune system. It seems to me that as long as Dr. A feels that he has exhausted all of the options to get Brian to tell his partner about his diagnoses, including warning Brian that he has a duty as a doctor to tell George about the risk Brian is putting him in and that is Brian does not disclose this information, he will have to tell George himself, then it is the doctors duty to tell George. Brian should also be made to consider the fact that George will likely stay with him after his diagnoses is revealed and George was not infected, but if George does become infected, George will likely leave him because of the deception and the fact that Brian knowingly put him at risk.
ReplyDeleteOverall, in my opinion, health care professionals have the duty to protect the health of others when their health is in serious danger and they can do something to prevent this danger.
Doctors have a duty to warn and sometimes it can override their obligation to maintain patient confidentiality. Dr. A in this case took the right measures of telling Brian how to manage the problem. That Brian should let his partner know about his HIV status and that they need to use protection. This is the most uncomfortable situation due to Brian's defiance and ignorance. Even though Dr. A and Brian have built the trust between them and its making the psychotherapy successful, still he should ask him to come with his partner to the therapy so that he may share with them about risks of having unprotected sex and the STD diseases that can be transmitted sexually. This would help out since Brian is afraid to initiate this conversation with his partner. Even though the confidentiality would have been breached indirectly, Dr. A would have helped protect the third party. Dr. a would also advice Brian and his partner to go together for HIV testing and even if one of them was infected, still they can be together if they truly loved one another.
ReplyDeleteThis is a very hard case. I believe that the doctor first should try their hardest to get the patient to tell the person at risk. If the patient seems to be totally opposed to the idea then the doctor should proceed to warn the patient even if it breaks the patient's confidentiality. Maybe an alternative to the doctor just going and telling Brian P's partner would be to have them both in his office. Dr A could ask Brian P to bring in his partner and they could all talk about it together. Understandibly his partner will probably be upset but it might go better if they have a professional there. Dr. A shoud bring the idea up to Brian about bringing his partner in together and see what he thinks.
ReplyDeleteAlthough I understand the importance of doctor-patient confidentiality, there are times when a doctor should override this privilege. Dr. A should do everything in his power to convince Brian to tell George the truth himself, including options that others suggested like having them get tested together and making Brian understand the danger he is placing George in. If Brian does not tell George, I believe that Dr. A should intervene, because an innocent man's life is being placed in danger.
ReplyDeleteBreaching confidentiality should only be done in situations where a person is in serious danger of hurting himself or others. If Brian refuses to tell George, his willingness to place George in harm's way would qualify this situation as one such exception.
I agree with what Kimberly said about the importance of doctor-patient confidentiality. I believe that the doctor should try in everyway possible to get Brian to tell George about him being HIV positive. If Brian refuses, I don't the doctor should necessarily stop treating Brian but should let him know that he disagrees with him not disclosing his status, especially if Brian is having unprotected sex, which may lead to transferring of an STD. If this were to happen, I feel the doctor should let Brians partner know about his status.
ReplyDeleteLike Melissa said, I think the doctor has an obligation that overrides confidentiality. The partner needs to know and has a right to know. As Marion said, the doctor should at least exhaust all other possibilities to get Brian to tell his partner on his own. If not, the doctor needs to let him know. The doctor could also have Brian's partner come in and have a talk with both of them. No matter what he does, Brian's partner needs to be notified.
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ReplyDeleteI agree with Jenna that the doctor should try his or her best to persuade Brian into doing the right thing and informing his parter. The doctor should push all possible outcomes of HIV, and well as informing him that if 10 years down the road Gary finds out his has been infected with HIV he will most likely leave Brian regardless. If this still does not work I think the doctor has every right to override patient confidentiality in protecting the harming of another being. It is correct that this could be considered in a way unintentional murder because HIV has the potential to be a very deadly disease
ReplyDeleteIf Dr. A wants to keep his medical licenses I am afraid he has to keep silent. His best bet is too urge Brian to tell George about his status. If Dr. A should also bring up the fact that if he does infect his new partner with HIV without his knowledge, that said partner can press charges and then the fact that Brian is HIV+ will be public knowledge and will only add to his feeling of social rejection and insecurity about his attractiveness. If Brian doesn't tell George now he could further ruin both of their lives. This is just a testament about how important it is to watch out for yourself. If you choose to have sex, hopefully not unsafe sex, you talk it over with your partner and get screenings if necessary. If George was concerned about his health and the health of his partner, he would ask for screenings.
ReplyDeleteI’m pretty sure that, in this case, that the doctor must not breech confidentiality. Not only does the oath protect Brian, IF the doctor did go and warn his partner and the partner rejected and broke up with Brian, that might further Brian’s depression and he might wind up committing suicide, or some harmful act of self-mutilation, so therefore no good would come out of the doctor exposing Brian. The believe that the only time someone should “breech” confidentiality is when the healthcare team is coming together to work on the appropriate plan of care for the patient. Dr. A should realize that even if he does say something to George, the doctor (I think) will lose his license, the doctor loses Brian’s trust, and potentially causes harm to Brian, and Brian spreads the word that the doctor squealed and nobody in the community will trust him.
ReplyDeleteDr. A should keep confidentiality with his pt so he does not lose everything he has worked for for his career. But Dr.A should keep urging Brian to tell his partner that he is HIV+ but he also needs to add the fact that serious repercussions can arise if he doesnt tell him, things such as passing on to him partner which could ruin his life and possibly lead to serious harm if he gets it and doesnt even know he was at risk. The doctor also needs to tell him that not telling him could result in a worse rejection compared the rejection he MIGHT get from his partner. Just like Christy said if the partner gets HIV then he could not only reject Brian but make sure it is known by many that he had HIV.
ReplyDeleteI do not think Dr.A should override his confidentiality with his patient. This is Brian P's decision to tell his partner about being HIV positive. All Dr.A should do is encourage Brian to share this information with his partners. It is ultimately Brian P's decision to let his partners know. Dr.A is supposed to listen and suggest ideas to Brian. He can only advise and encourage but never over step the patient-doctor boundaries.
ReplyDeleteA patient-doctor relationship is very important and can be very hard to build when dealing with someone that has an illness such as depression. Dr. A has done a well job with Brian, but he needs to continue to push the fact that Brian needs to tell George of his status. If this is the first time that Brian told Dr. A that he is having unprotected sex with George, then I do not think that Dr. A needs to find George and tell him right away. I would suggest Dr. A to keep explaining to Brian the consequences of unsafe sex and maybe as stated above have the two of them get tested together. Getting tested together will allow them to both find out at the same time their status and it could be a better way for George to find out about Brian rather than Brian having to come up with a way to discuss a hard topic. However, if a couple is having sex, they should comfortable enough to talk about things that can help them stay healthy and protected. If Brian continues to see Dr. A and tell him about his unprotected sex, then yes, Dr. A should tell George what is going on. But, then there is the issue of how would Dr. A get ahold of George with out Brian knowing right away or finding out. Doctors should not brief confidentiality unless their pt is harming themselves or others. Brian could sooner or later infect George with HIV putting George in a bad situation. So, as stated earlier Dr. A should tell George if Brian doesn't after talking to Dr. A.
ReplyDeleteI think health professionals do have a duty to warn depending on the situation. If the patient threatned to kill someone and mentioned it seveal times then it is their duty but with HIV I think it depends on if another person is in danger as in this case. Brian mentions several times about the unprotected sex and Dr. A has tried several times explaining to Brian the risks of it. I see where Brian is coming from with the rejection but he can't put others at risk because of that fear. As brittany stated if a couple is having sex then they should be comfortable enough to discuss these issues but that is not always the case. In this case I think Dr. A should tell George about Brian's status.
ReplyDeleteI basically think that a doctor only has the right to break confidentiality only if someone else's life is at risk or is threaten. In this case, I believe George's life is at risk because he has a chance of catching HIV. Even though there is a new combination of drug therapies to manage the HIV, the virus is still putting his life at risk if he catches it from Brian. Before Dr. A breaks patient confidentiality, I think he should keep on strongly encouraging Brian to tell George about his HIV status. Also, if he keeps explaining how easy it is for George to catch HIV from Brian since they are having unprotected sex, then maybe that will get into Brian's head that he should tell George. If Brian continues to say that he doesn't want to tell, then that is when Dr. A should break confidentiality and tell George for the sake of his health.
ReplyDeleteI believe that Brian should tell his partner George that he is infected with HIV. It is not only a danger to George, but also Brian to have unprotected sex. Geroge could contract the HIV from Brian, or Brian could be put in danger by contracting another disease, due to his compromised immune system. I also believe that Dr. A should do his or her best efforts to persuade Brian in changing his decision to keep his status a secret, and also his decision to have unprotected sex. Hopefully, once Brian knows that his decisions may affect his own health, he may change his mind. I still think it would be a risky decision for Dr. A to go behind Brian's back, given that they have a trusted relationship built. Brian is supposed to be able to confide in his doctor, and breaking this confidentiality would be damaging to that relationship. However, if the confidentiality rule is not broken, the consequences may be worse.
ReplyDeleteI think that Brian should tell his partner and if not the Dr. should keep trying to encourage him to do so because if may affect him. I know that people don't always want to tell someone something because they will feel rejected by them. So if Brian does not tell his partner, George, then the doctor has the right to contact George because Brian has HIV. So George's life is at risk for HIV since they are having unprotected sex which can transport the virus.
ReplyDeleteThe Doctor needs to encourage him and tell him how easy it would be to catch the virus. The doctor needs to tell him all the risk possible and if Brian doesnt say anything then the doctor should break the patient confidentiality
I agree with the majority, Brian should tell his partner. The Dr on the other hand should not break confidentiality. He can strongly encourage Brian to tell his partner, and hopefully with further therapy Brian will tell his partner. Now as far as the concern for are there times to break confidentiality, the answer is no. There are ways around breaking confidentiality. For example if someone says they are going to kill them then they can contain him perposing the threat without breaking confidentiality.
ReplyDeleteClearly, I think Brian should tell his partner. Brian has a false notion of HIV and he needs to realize that safe sex and honesty is the best way to go. I do not think Dr. A should breach confidentiality, however. I think he should continue to educate Brian about HIV and protected sex and hopefully get Brian to tell his partner. I think the only time a Dr should breach confidentiality is when there is a valid threat against another person. In this case, I don't think Brian wanted to harm his partner in any way.
ReplyDeleteI feel that as healthcare professionals we all have a hard decision to make when it comes to telling family, friends, or lovers about HIV statuses. I feel that it is better to convince the patient to tell who ever he/she needs to tell, rather than telling yourself. HIV is a very serious and dangerous disease and can not be kept a secret from people who could contract it. It does not mean that healthcare providers should take the initiative to tell people. I think that Dr.A should talk to Brian more and ask him to stop having unprotected sex until Dr.A and him can come to an agreement on what to do about George. It could also be beneficial to Brian to teach him on HIV since he has misconceptions about the disease and transmission.
ReplyDelete