Brian B. and The Medical File Test

Brian B. is taken into an exam room in the office of Dr. K. by the medical assistant, Amy. Amy gets into an animated discussion with Brian about their mutually favorite baseball team. As Amy leaves the exam room, she accidentally places Brian’s medical file on the counter. While Brian waits for Dr. K., he reads through his file folder. He is shocked to discover that his recent test for AIDS came back positive. Brian panics and runs out of the office before seeing Dr. K. The doctor tries to reach Brian by phone but there is no answer. Dr. K. then sends a letter marked “Confidential” to Brian and explains that he must be treated for his disease and also needs to inform his sexual partners about his disease. Brian does not respond to the letter.

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What else can Doctor K. do to meet his obligation to report a communicable disease? In dealing with outbreaks of communicable diseases, Doctor K. should work with public health authorities to promote the use of interventions that achieve desired public health outcomes with minimal infringement upon individual liberties. In implementing such measures, Doctor K should take necessary actions to promote the patients’ well-being. In addition, Doctor K should also be responsible for taking appropriate precautionary measures to protect the health of individuals caring for patients with communicable diseases. Physicians are ethically obligated to safeguard patients’ privacy and should not reveal confidential communications or information without the express consent of the patient, unless required to do so by law.24 Therefore, physicians must comply with legal requirements to report affected patients to appropriate public health authorities.

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