Ethics Opinions

Physicians should engage patients whose capacity is impaired in decisions involving their own care to the greatest extent possible, including when the patient has previously designated a surrogate to make decisions on his or her behalf.

Physicians have an ethical obligation to be considerate of patient concerns and anxieties and ensure that patients receive test results within a reasonable time frame.

Physicians have a responsibility to protect the confidentiality of minor patients, within certain limits. In some jurisdictions, the law permits unemancipated minors to request and receive confidential services relating to: contraception, pregnancy testing, prenatal care, delivery services and care to prevent, diagnose, or treat sexually transmitted disease, substance use disorders, or mental illness.

Physicians have an ethical obligation to preserve the confidentiality of information gathered in association with the care of the patient. With rare exceptions, patients are entitled to decide whether and to whom their personal health information is disclosed.

In general, patients are entitled to the same respect for the confidentiality of their personal information after death as they were in life, with a few exceptions. Physicians have a corresponding obligation to protect patient information, including information obtained postmortem.

Physicians may obtain personal information about patients outside an ongoing patient-physician relationship. When conducting third-party assessments or treating work-related medical conditions, physicians have a responsibility to protect the confidentiality of patient information.

Information gathered and recorded in association with the care of a patient is confidential. Disclosing information to third parties for commercial purposes without consent undermines trust, violates principles of informed consent and confidentiality, and may harm the integrity of the patient-physician relationship.

When there is reason to believe that patients’ confidentiality has been compromised by a breach of the EMR, physicians have a responsibility to follow ethically appropriate procedures for disclosure. The degree to which an individual physician has an ethical responsibility to address inappropriate disclosure depends in part on his or her awareness of the breach, relationship to the patient(s) affected, administrative authority with respect to the records, and authority to act on behalf of the practice or institution.

In handling patient data, individual physicians should balance supporting and respecting patient privacy with upholding their ethical obligations to the betterment of public health. The use of data for the benefit of public health should be treated as a form of public good in which the standards and values of health care should follow the data and be upheld and maintained. Those with access to datasets have a duty to uphold the ethical values of health care in which the data were produced.

Human participants who contribute to research involving DNA databanks have a right to be informed about the nature and scope of the research and must give consent for how their information may be used.