A 33-year-old man is brought to the emergency department by his mother because of erratic behavior over the past 6 months. He spends most of his time alone in his room because he believes he is being followed by the Secret Service. He was fired from his job 3 months ago after threatening a colleague. He appears suspicious of his surroundings and asks the doctor questions about “the security of the hospital.” The patient exhibits a flat affect. During physical examination, he tells the doctor that he has a gun at home and plans to shoot his neighbor, whom he thinks is working for the Secret Service. Which of the following is the most appropriate action by the doctor?
ARequest a court order to override the patient's right to confidentiality
BDiscuss the diagnosis and therapy plan with the patient's mother
CInform security and law enforcement
DAdminister haloperidol and request a psychiatric consultation
EWarn the person at risk and inform law enforcement
A 42-year-old woman presents to the physician with symptoms of vague abdominal pain and bloating for several months. Test results indicate that she has ovarian cancer. Her physician attempts to reach her by phone multiple times but cannot reach her. Next of kin numbers are in her chart. According to HIPAA regulations, who should be the primary person the doctor discusses this information with?
AThe patient's brother
BThe patient's husband
CThe patient's daughter
DAll of the options
EThe patient
A 17-year-old male, accompanied by his uncle, presents to a doctor with his arm in a sling. There is blood dripping down his shirt. He pleads with the physician to not report this injury to authorities, offering to pay extra for his visit, as he is afraid of retaliation from his rival gang. The physician examines the wound, which appears to be a stabbing injury to his left anterior deltoid. This case study in medical ethics asks: How should the physician best handle this patient's request?
AMaintain confidentiality, as reporting stab wounds is not required
BBreach confidentiality and discuss the injury with the uncle
CBreach confidentiality and report the stab wound to the police
DMaintain confidentiality and schedule a follow-up visit with the patient
EMaintain confidentiality, as retaliation may result in greater harm to the patient
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