Patient-physician confidentiality question

I was chatting with the ex the other day, and catching up on people I no longer see. An inquiry about one couple revealed the surprising news that they’d divorced. While definitely an unusual pair of folks, they’d been together for 25 years and appeared to be quite devoted to each other. What happened?

It seems hubby’s doctor called Mrs. Hubby to his office and advised her that he had treated hubby for STDs 6 times in the previous year and had come upon the knowledge during the course of these treatments that hubby was (and, I would guess, probably still is) a regular participant in the goings on at adult book stores (obviously not in protected mode).

So they quickly divorced.

My question is, and consider that this woman was not a patient of this MD, did the doctor violate patient-physician confidentiality by revealing what he knew to her?

This is really an academic inquiry - I have no problem at all recognizing that slug-puppy hubby was exposing the Mrs. to risks unknown to her (fortunately the big one amongst STDs apparently didn’t come down the pike, or however you’d care to put it).

Informing the wife of husband the details regarding her husband was a breech of Dr.-pt.confidentiality. The Dr. should have advised hubby to have his wife tested…to use protection. But to betray details that hubby gave him to the wife without hubby’s permission is a definite no-no.

Without knowing all the details, it’s hard to say. If the doc knew hubby was an active threat to her health and life, he’d be legally and ethically obliged to break confidentiality. And in this day of AIDS and HPV, which can cause cancer, that’s not so far fetched. And if Hubby had syphilis, gonorrhea, or chlamydia, that’s an automatic obligatory report to the Public Health Department, who will track down all of hubby’s contacts to get them treated too. So in short, I’m not sure if the breach was ethical, but the odds are it was.

Qadgop, MD
speaking off the top of his head again!

Let me amend my reply by saying I don’t think it was ethical for the doc to give the woman details and circumstances, if that’s what occurred. But I suspect he was probably obliged to give her the basic info about the risks to herself due to exposures to known STD’s. (sexually transmitted diseases).

I’ve transmitted (eewww!) all the details I know.

Threat is not in question, nor, I would think, is active (i.e., ongoing - 6x in a year - message not being absorbed by recipient). Since HIV, or AIDS, has not appeared, I would guess that hubby contracted one of the other three that Qadgop mentioned that apparently require public reporting. I can’t think of too manny others - he got crabs 6 times in a year? Trich? There’s undoubtably some of which I’m (bissfully) unaware.

I didn’t think there was any circustance in which a doctor was legally obliged to break patient confidentiality, unless they were issued with a subpoena to give evidence in court (disclaimer - I’m British - might be slightly different laws over here)

So, do the Public Health Department over there breach patient confidentiality or do they just inform the patients’ contacts that they may have been exposed to a certain disease without revealing the details?

Oh, in the states there’s plenty of situations which require you to break confidentiality. “Clear and present danger” is one. Say a patient tells his doc he plans to kill his boss. If the doctor withholds that information from authorities or the person threatened, he can be imprisoned, lose his license, get sued big time, etc. And the public health agencies will tell a person that they’ve been reported as a sexual contact of individual X, who has a known communicable disease, and they will track treatment. Despite some allegations about the US, individual rights do not always win over public welfare. And of course, there’s lots of grey areas, where if you break confidentiality you can get sued, and if you don’t break it you can get sued. Never a dull moment.