HPV and release of information?

[canary90]

Hey there!
I came across an ethics question in Uworld which I find somewhat confusing. Can someone please help me with this:

A 40 yr old woman presents with genital warts. She admits having extramarital affair. Later the physician receives a call from her husband inquiring about her health as he is concerned about his physical symptoms
Most appropriate response by the physician:
And the correct answer was: "If your spouse is a patient here, she would have to provide a release of information."
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So this is a case of HPV genital warts which is considered an STD. Shouldn't the physician be allowed to break the confidentiality in this case as the virus can be potentially transmitted to her husband?

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[Phloston]

You never break confidentiality to a spouse/family without patient permission. This question is exceedingly HY.

Doesn't matter if spouse of 60 years comes in and wants to know something seemingly trivial. You need patient consent first.

 

[canary90]

Thanks for the reply!
I understand that confidentiality must never be broken. You would definitely not inform the spouse if the patient has a non-communicable disease like cancer or so but there are few exceptions where confidentiality can be breached in order to prevent harm to others. These exceptions include partner notification in case of STD, a communicable disease like TB or if a patient confides in telling you that he intents to harm someone. In these cases breaking confidentiality becomes essential to in order to prevent harm to others.
Even in Uworld, its mentions that partner notification should be done in case of HIV, syphilis etc.
So why not in case of genital warts due to HPV, because its an STD too, if I am not wrong ? :S

 

[MrWonderful]

Summary of Scenarios:
1. Patient has non-communicable Dx --> don't tell the partner

2. Patient has non-communicable Dx, but partner is also a patient of yours (this is a boards favorite) --> don't tell the partner

3. Patient has a "Reportable Disease" --> contact health agency (required by law). These diseases include Hepatitis, HIV, Syphillis, Gonorrhea, Measles, Mumps, Rubella, Chicken Pox, TB, Salmonella, Shigella. See this helpful video to learn a song that will allow you to memorize these Reportable Diseases in 1 minute or less.


NEVER break confidentiality. NEVER use patient names or information in public (boards favorite as well -- ex: eating at a restaurant and your patient walks by, person with you presumes its your patient and asks you if they are your patient, your answer should be "I cannot comment on if they are my patient or not.")

 

[canary90]

Summary of Scenarios:
1. Patient has non-communicable Dx --> don't tell the partner

2. Patient has non-communicable Dx, but partner is also a patient of yours (this is a boards favorite) --> don't tell the partner

3. Patient has a "Reportable Disease" --> contact health agency (required by law). These diseases include Hepatitis, HIV, Syphillis, Gonorrhea, Measles, Mumps, Rubella, Chicken Pox, TB, Salmonella, Shigella. See this helpful video to learn a song that will allow you to memorize these Reportable Diseases in 1 minute or less.


NEVER break confidentiality. NEVER use patient names or information in public (boards favorite as well -- ex: eating at a restaurant and your patient walks by, person with you presumes its your patient and asks you if they are your patient, your answer should be "I cannot comment on if they are my patient or not.")

Thank you very much for replying and sharing such an important piece of info!

 

[Kazaki]

Reportable disease--> Report to local public health officials, they've gotta report to the CDC and inform spouse/partners as well

 

[MrWonderful]

The Reportable Disease part is high yield. Step 1 loves asking about that stuff

 

[Md Blast]

Reportable disease--> Report to local public health officials, they've gotta report to the CDC and inform spouse/partners as well

To my understanding you report to CDC/health officials & THEY report to partner/spouse. In the end you still do NOT directly report to spouse/partner.

 

[Kazaki]

To my understanding you report to CDC/health officials & THEY report to partner/spouse. In the end you still do NOT directly report to spouse/partner.

Not to the CDC, just the local health department, which then contacts the spouse. The local health department sends a report to the CDC every x number of months to tell them we had x number of reported cases of syphilis, which the CDC then uses to make all the boring epidemiological data we have to know.
It would be mayhem @CDCHeadQuarters if they were receiving calls from every doctor in the country that wanted to report a disease.
Even for diseases like the plague, you still report to the local health department, but for such diseases, they contact the CDC almost immediately.
Hope that helps.