I am an ex associate - 04 August 2008 04:45 PM

Unfortunely there are several things in medicine that are left unsaid.  Whether it is known to the family knows about the genetic situation may never be comented on unless there is a major lawsuit which may never happen.  A lawsuit would happen if the patient or the family suspects malpractice or a mistake of some sort.  Hospitals (in my limited experience) are very bad in admitting mistakes, if they find out about them.  Mistakes are made by doctors and nurses that are never found out.  Long term care is better about admitting that something happened.  So unless legal stuff happens, in real life, these two may never know. Few people ask for a complete record of their medical files

But I believe the question is about what is ethical—not necessarily about how hospital staff actually behave.

To be or not to be.

DJ_Canada - 04 August 2008 09:00 PM

To be or not to be.

That is another question altogether!

Actually suicide and physician-assisted suicide is another good medical ethics topic. . . .

This may be a discussion on the theory of medical ethics.  I work the reality.  These two do not always mix

I am an ex associate - 05 August 2008 04:37 PM

This may be a discussion on the theory of medical ethics.  I work the reality.  These two do not always mix

Are you saying medical professionals are unethical?  I’m shocked! 

The case in question, though, isn’t about a mistake.  It’s about disclosing the results of a test that revealed that the father wasn’t actually the girl’s biological father. 

Huli says that it’s not pertinent to the organ transplant (even though I think it is, if only slightly), so the hospital should note this in their files, turn over the information to the “authorities”, but withhold that info from the father and daughter lest it cause them emotional suffering.

(I’m not sure what “authorities” should have this very personal information that we’re keeping from the people involved!)

On the one hand, I understand the argument that the two didn’t come in for a paternity test, but I should imagine that a determination of paternity is a reasonably expected result of the test.  (I recall reading research that showed that a surprisingly high percentage of babies born to married couples weren’t fathered by the father/husband.  I don’t remember the stat—maybe 10%?)  At any rate, this is certainly something that should have been anticipated as a possible outcome.  As Huli mentioned earlier, this really should have been covered in some sort of standard form that everyone signs ahead of time so there’s no doubt as to the patients’ preference to remain ignorant or be informed.  (I can’t imagine this situation is so rare that it hasn’t happened before.)

In the absence of such a form, I’d go back to what I said—the test results belong to the patient.  The records in their file belong to the patient.  I can’t see letting other professionals (or “the authorities”) know about such private information while withholding it from the father and daughter.