Dilemma

Before I tell this story, let me just express my intense hatred of all Microsoft programmes. I hate my Microsoft. It is unpredictable and unreliable. I hate it hate it hate it hate it hate it. That off my chest, lets begin...

I recently saw a patient with a serious medical condition and another, even more serious, underlying medical condition.

The patient was started on treatment for the one condition but treatment of the other condition was delayed.

The patient then returned. He had applied for temporary disability leave form his employers and had brought a ton of some forms for me to fill in. Included with these millions of one or two forms was a consent form. The consent form stated that the patient grants permission to his doctor/medical practitioner/health care professional/nurse/any other person who has ever had any medical contact whatsoever with the patient ever to disclose any and all medical conditions/blood results/lab reports/x-rays/correspondence about/any medical information whatsoever pertaining to the patient. Basically.

I asked him if he understood what this form meant and he seemed to have no idea, so I told him that it meant that I could tell his employers about all his medical problems, including the very serious medical condition that he had, and give them copies of all his blood results, etc. He said that he only wanted me to tell his employers about the less serious illness. Again I explained to him that he had signed this form and that it was a legal document giving me permission to disclose all his medical information. He said that he did not want his employers to know about the underlying condition.

This obviously left me in a bit of a predicament. I now had to decide whether I should fill in the forms in their entirety as the employers requested on their forms, in view of the signed consent, or whether to only disclose information about the one condition.

I wasn't sure what the legal implications were - whether I was legally obligated to disclose, all things (including a signed consent form) considered. I reasoned though that consent is fluid and that a patient is allowed to withdraw their consent at any time. I also felt that my ethical obligation to the patient outweighed any other present obligations.

So I filled in the forms, only disclosing information about the one condition and indicated that the patient had asked me not to disclose any other information. There was also a "declaration" section which I had to sign which stated that all information I supplied was true and correct. I had no problem with that, but it also stated that I had not withheld any information. I drew a line through that section and signed it.

Afterwards I felt uneasy about the whole situation and sought legal advice from the medico-legal society of which I am a member. I was advised that I had done the right thing and that I was legally in the clear. I was relieved but felt that I had always been morally in the clear.