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Duty to warn: when should confidentiality be breached?
1Department of Family Medicine, Medical College of Georgia, Augusta.
The Journal of Family Practice
|February 1, 1990
Summary
Family physicians face a dilemma balancing patient confidentiality with the duty to warn potential victims of foreseeable harm. This study offers guidelines for assessing threats and responding to patient violence.
Area of Science:
- Medical Ethics
- Forensic Psychiatry
- Family Medicine
Background:
- Physicians grapple with the ethical and legal conflict between patient confidentiality and public safety.
- Court rulings mandate protecting society from foreseeable danger while respecting patient privacy.
Purpose of the Study:
- To explore the ethical dilemma faced by family physicians regarding breaching patient confidentiality.
- To provide guidance on assessing patient dangerousness and responding to threats of violence.
Main Methods:
- Case report analysis.
- Review of legal precedents and ethical guidelines.
- Development of practical recommendations for physicians.
Main Results:
- The legal and ethical framework supports a duty to protect intended victims from specific threats.
- Assessing dangerousness requires careful consideration of patient history, threat specifics, and risk factors.
- A structured approach can help physicians navigate these complex situations.
Conclusions:
- Family physicians must balance confidentiality with the duty to warn when faced with specific threats of harm.
- Clear guidelines are essential for physicians to make judicious decisions in high-risk situations.
- Proactive assessment and intervention can mitigate risks to both patients and the public.