I am looking for ethical guidance here. Assume that the there is a strong correlation between salt use and high blood pressure (there is a related question on that in GD).
I have a friend who has very high and poorly controlled high blood pressure. She takes meds but they don’t bring it down to a safe level. She doesn’t smoke and is painfully thin (about 95 lb at 5’4"), not from lack of eating, but that is her metabolism. One night I was at a restaurant with her and several other people. The restaurant serves a plate of olives and pickled vegetables when you sit down. She started glomming the olives, but carefully salted each one of them. She uses the same GP as me. My question: should I tell him what I witnessed or should I keep out of it?
Keep out of it. It’s a)not your business, b) both illegal and unethical for him to discuss her medical issues and treatments with you without her explicit written permission, and c)not anything he can do anything about.
You should absolutely not mention anything to your GP. Going behind her back to talk directly to the GP crosses the line of doctor-patient confidentiality. You are also basically taking a position of superiority over her and not acting as a friend. You are basically saying I know what’s better for you than you do, so I am going to conspire against you with your GP, which is not a friend to friend peer relationship.
If you want to say something, say it directly to your friend, as a peer. Don’t say something like “stop that, it’s bad for you.” Instead, say something like “doesn’t that bother your blood pressure when you do that?” Show concern and act as a friend. Don’t talk down to her like a parent.
I happen to have high blood pressure which is controlled by meds. Some people do have to watch their salt intake very carefully, some don’t. I happen to be in the “don’t” category. It is possible that she can glom down the olives and not be affected by them.
I’m not completely convinced it’s absolutely ethically unthinkable, but do think it’s too trivial to mention to the doctor. (If it was something way more extreme, I’d have to consider the ethics, but not in this case).
And I completely agree with this:
Except, I’d phrase it as a real question “Does that bother your blood pressure?”, because
Point B is moot if the doctor says nothing in response that discloses confidential information. The OP can convey information without the physician violating HIPAA/other privacy rules.
Going to the GP in this case is the wimp’s way out, IMHO. What you need to do is tell your friend youa re concerned, and why. Just be honest. “It worries me when I see you do things like that.”
Question for the poster’s above: Is it really a confidentiality violation for a doctor to listen to what you have to say about their patient? I mean, the doctor wouldn’t even have to admit to seeing the patient, and no feedback is necessary. If he said, “Oh yes, her blood pressure is x over x and she should not be doing that” then yes, it’s a violation. But just listening?
Are you sure she has hypertension and not hypotension? I’m just curious because of the misspelling in the title. Perhaps you misunderstood her condition?
I ask because I have the latter (which is actually really low blood pressure) and I am also about 95 lbs and stick thin. It seems to be pretty common for small/thin people to have low blood pressure. My cardiologist has ordered me to increase my salt intake. I put extra salt on everything and I take salt tablets several times a day along with blood pressure medication.
I don’t misunderstand. Unmedicated it was well over 200 and even with drugs it stays well above 150.
But I didn’t and will say anything to the GP in question. As for saying something to her, well, I can assume the GP tells her to reduce her salt since he says the same to me and my pressure is well controlled by drugs (and not nearly that high to begin with). Yes, it was a trivial incident, but I am afraid it was symptomatic.
I would maybe say something to her (maybe–if you feel you know her well enough) but never say something to her doctor. I hate to use the word “tattling,” but this is an example where telling someone something would definitely be tattling. And just creepy.
How do you know so much about her health? If she goes on about it to you, then she’s pretty much inviting your input, so feel free to say something to her directly.
Not sure how old you are, but I had a friend in high school (I assume you’re older than that if you’re thinking of blood pressure) who did exactly that with olives, pickled onions and sundried tomatoes – loaded them with salt – because that was pretty much all she ate. There’s also a pretty well-known model trick of dumping salt all over your meal when you’re half done, so you won’t eat anymore. Probably not relevant, but thought I’d put it out there (hey, that could be my signature).
Cat Fight, I’ve also heard of the trick of putting salt and pepper on bread so you will feel full faster (that is, you’ll feel that a bit of bread and butter is a full meal).
Just to clarify, I didn’t mean to imply that a GP couldn’t listen to this story about the salty olives, just that he can’t respond to it in any way beyond “Uhhhh, good to know?”