The patient in this vignette


The patient in this vignette is most likely the victim of elder abuse, which is one example of when patient confidentiality must be breached and the condition reported.

A physician has an ethical responsibility to his or her patients to respect and protect their confidentiality in nearly every situation. The following cases are exceptions to this rule:

(1) the patient expresses intentions to harm his/her self or another;

  1. suspicion of child or elder abuse;
    (3) signs of a violent assault crime (e.g. gunshot or stab wounds); and

(4) diagnosis of a reportable communicable disease.

McCunney outlines the need to preserve patient confidentiality, as described in the codes of conduct from the American Medical Association, the American College of Occupational and Environmental Medicine, as well as relevant parts of the Americans with Disabilities Act of 1970. These resources can help physicians make informed decisions about patient medical information.