In this Episode, you are the head of Information Technology (IT) Services. Dr. Jones pages you to come to his office regarding a rather sensitive matter. As he was verifying the intranet lab results for his patients, he noticed that one of the patients had a positive Syphilis test. The patient is a board member for the community health center and is a highly respected member of the community. He serves on a number of philanthropic boards, sings in the church choir, has a loving family, and contributes large amounts of money and time to the Community Health Center. You know very little about Syphilis so he/she talks with the CNO. You learn that Syphilis is a reportable disease in the state (part of the public health law). This means that the patient’s name must be submitted to the state health department. The patient will be contacted by the health department and will be asked to provide names of sexual contacts. Dr. Jones checks with another physician as to how this issue has been handled in the past (perhaps before electronic records); the physician says the best thing to do would be to get the patient to tell the spouse, as the spouse will be contacted by the health department (and it is certainly better to hear this type of news from the spouse as opposed to a stranger). Even after receiving all of this information, Dr. Jones asks you to purge the electronic record of the test results and not submit the name to the state health department. Dr. Jones bases this request on the physician/patient privilege, confidentiality issues, and even the Hippocratic Oath (telling you that it includes “do no harm” and the doctor knows that this issue will harm the patient’s reputation and possibly his marriage). Your decision: There are many issues to consider in this decision, namely the extent to which physician/patient privilege extends, the ethics of a physician and a hospital breaking the law in order to protect a donor, the responsibility a physician has to the spirit of the law and protecting a community, and the good of the individual vs. the good of the community. You will need to consider these issues because they impact the Community Health Center. Based on the information you gather and ethical issues you consider, you will tell the physician what you decide, why you made the decision, and how the physician should proceed with his patient.
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