■ Professionalism and ethics:
Integrating professional duties, societal expectations and personal wellbeing
Breach of confidentiality
Type of activity: Text case
This short text case portrays an emergency physician's breach of patient confidentiality. The facilitation questions and suggestions to faculty are focused on helping learners to understand breaches of confidentiality and mandatory reporting requirements
A 46-year-old is brought to the emergency department after crashing her car into a pole. She smells of alcohol, has slurred speech and is combative with the staff. The patient’s co-workers are present and ask the physician for an update on the patient’s status. The physician confirms that there are only minor injuries, but the patient’s blood alcohol level is three times the legal limit.
- Did the emergency physician breach the patient’s confidentiality? What would have been an appropriate response to the co-workers?
- How should the physician respond, and what additional considerations are required if the police request a patient’s personal health information or blood alcohol levels?
- What are some conditions that require mandatory reporting of a patient’s health conditions in your province/territory?
- Should you generally advise the patient when you make a mandatory report naming them?
- Can you identify other scenarios where physicians might breach doctor-patient confidentiality when responding to inquiries?