Confidentiality and Disclosure in Medical Practice

Ethical Dilemma and Stakeholders

One can assume that the couple visited Dr. Friendly to seek a friend and family physician’s advice that served them for 30 years. However, Dr. Friendly wanted Mr. Lovebird to have informed consent with regards to his future decisions. This is the first ethical dilemma.

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The family physician became defensive, and in the attempt to appease an angry Lancelot, Dr. Friendly discussed his patient’s medical problem. Mr. Lovebird fired back, saying that the physician was in serious breach of professional responsibility. This is the second ethical dilemma.

There are two major stakeholders in this case. The first significant stakeholder is Mr. Lovebird. The second major stakeholder is Dr. Friendly. From Mr. Lovebird’s point of view, Dr. Friendly is a confidant, friend, and medical adviser. Nevertheless, he expected the matter to be kept private. From the point of view of Dr. Friendly, he was thinking of as a friend, and he wanted Mr. Lovebird to have informed consent. From the point of view of Mr. Lovebird, the physician was wrong to discuss the matter with other people without the permission of the patient.


In his defense, Dr. Friendly will argue using the concept of “informed consent.” In this particular ethical framework, the physician wanted to address the following elements: competence, freedom from coercion or influence, and relevant information (Hayry, Takala, & Herissone-Kelly, 2005). Based on this framework, Dr. Friendly felt obligated to tell Mr. Lovebird about his condition. However, there is one problem. The physician did not have the strength to say to the couple that palliative care is the best option for them. Going back to the said framework, one can deduce that the physician wanted to help by forcing the concept of “informed consent.” Dr. Friendly’s decision to compel the couple to realize the importance of “informed consent” was done in an unprofessional manner. The attempt to persuade came via an indirect method, and it meant discussing confidential information outside the physician’s office. The message was delivered through someone who cannot decide for Mr. Lovebird.

Thus, what he did was a serious breach of professional responsibility (Gardner & Suplee, 2010). He cannot use “informed consent” to justify his actions. First of all, he did not talk about it when he had the chance. It was his responsibility to inform the patient. Due to his longstanding relationship with the Lovebirds, he could not discuss the issue in an objective manner. Prudence should have dictated that the best course of action was to keep silent or to refer them to an oncologist who can give them an unbiased opinion about the matter. Even if Dr. Friendly was determined to enforce the ideals of “informed consent,” he did not have the credentials to discuss why palliative care is a better option compared to chemotherapy. In addition, actions regarding “informed consent” must be directed towards the patient, not the family members. If Dr. Friendly wanted Mr. Lovebird to seriously consider palliative care, he should talk to the patient and not Lancelot. Mr. Lovebird was correct when he said that the physician committed a serious breach of professional responsibility.


Gardner, M. & Suplee, P. (2010). Handbook of clinical teaching in nursing and health sciences. MA: Jones & Bartlett Publishers.

Hayry, M., Takala, T., & Herrissone-Kelly, P. (2005). Bioethics and social reality. New York: Rodopi.

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