In 1976, the California Supreme Court ruled in the case of Tarasoff v. Regents of the University of California that a patient’s right to confidentiality “ends where the public peril begins.” It was decided that doctor-patient confidentiality could—and should—be broken if the doctor believes a patient will cause serious harm to another person. In his article entitled “A Defense of Unqualified Medical Confidentiality,” Kenneth Kipnis argues that doctor-patient confidentiality should always be kept, contrary to the findings of the Tarasoff case. He presents the fictionalized case of the infected spouse to clarify his argument. In this case, a husband learns from his doctor that he is HIV positive. Soon after, he tells his doctor that he will be
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They may say that under unqualified confidentiality, they cannot disclose this sensitive information to anyone, thus making their knowledge of it useless. Kipnis (2006/2008) replies by saying that “there is only one thing they cannot do: disclose” and that “[a]ll other paths remain open (p. 56). He explains that there are other options for preventing harm to a third party without breaching confidentiality, such as attempting to convince the patient to agree to have the information disclosed. He speaks of a clinician who was able to persuade the majority of his patients to agree to have their spouse notified of the risk they faced (Kipnis, 2006/2008, p. 56). If a doctor can find creative ways to disclose the risk without breaking confidentiality, then he has upheld his moral duty to his patient and his legal duty to the endangered person. Even if they are unable to get their patient to agree to the disclosure, they have lived up to the obligations of their profession. Kipnis (2006/2008) concludes his argument by stating that “confidentiality… is effective at getting more patients into therapeutic alliances more quickly, it is more effective in bringing about better outcomes for more of them and—counterintuitively—it is most likely to prevent serious harm to the largest number of at-risk third parties” (p. 56). He is adamant that confidentiality and trustworthiness are the professional, moral requirements of doctors, and they are not to be broken even if legal precedent requires
They may say that under unqualified confidentiality, they cannot disclose this sensitive information to anyone, thus making their knowledge of it useless. Kipnis (2006/2008) replies by saying that “there is only one thing they cannot do: disclose” and that “[a]ll other paths remain open (p. 56). He explains that there are other options for preventing harm to a third party without breaching confidentiality, such as attempting to convince the patient to agree to have the information disclosed. He speaks of a clinician who was able to persuade the majority of his patients to agree to have their spouse notified of the risk they faced (Kipnis, 2006/2008, p. 56). If a doctor can find creative ways to disclose the risk without breaking confidentiality, then he has upheld his moral duty to his patient and his legal duty to the endangered person. Even if they are unable to get their patient to agree to the disclosure, they have lived up to the obligations of their profession. Kipnis (2006/2008) concludes his argument by stating that “confidentiality… is effective at getting more patients into therapeutic alliances more quickly, it is more effective in bringing about better outcomes for more of them and—counterintuitively—it is most likely to prevent serious harm to the largest number of at-risk third parties” (p. 56). He is adamant that confidentiality and trustworthiness are the professional, moral requirements of doctors, and they are not to be broken even if legal precedent requires