interesting interview question

[StreetballKing]

I would have them both sit in the room, then tell them both results. It can be hard but I think this is the best "ethical" decision. I'll also recommend the husband to get re-tested because the test might not be correct 100% of the time. Eventhough this decision might destroy the couple's relationship, but it is still better than concealing information right?

[JohnDakota]

Firstly, the absolute worst thing would be to jump to conclusions. Infertility is a functional definition. A person, or couple are determined to be infertile if after a full year of unprotected and properly timed intercourse the woman has not conceived.

 

Sure you could determine likelihood of infertility in the male through blood tests, or direct observation of the man's ejaculate, however those also do not mean zero possibility. There are instances where men who have been 'fixed' have reportedly still impregnated women.

 

Anyway let's assume hypothetically that the man could not have impregnated the woman (he's a eunuch or something). Then you're in a apparently difficult situation since you are both the man's doctor, and hence his advocate, as well as the woman's doctor and her advocate. Do you break Dr-patient confidentiality with the woman? I would say no. This is not an instance where you've diagnosed a communicable disease like HIV, nor is it a situation where the man is any sort of immediate danger. You are also not their marriage councilor, and even if you were there is no law which forces you to break confidentiality if you've discovered someone committing adultery, even if you were 100% certain.

 

Imagine if doctors were compelled to break confidentiality to snitch on someone who was cheating on their wife/husband? Husband X comes in to see you because he's afraid he was exposed to the Clap with a prostitute, and you have to tell his wife. That would be ridiculous. Nobody would seek proper medical attention under those circumstances, which is why it's in societies beset interest that confidentiality be maintained.

 

So while I may speak privately to the woman about her conception and the circumstances, I would be VERY careful about what I said, particularly in the chance that she had not actually cheated on the husband. If she had not (or even maybe if she had cheated!), that's a 100% assured way to lose 2 patients. If it turns out she did cheat, then I would suggest she see a councilor to talk about how to go forward with the situation appropriately. But ultimately it's up to the woman to tell the husband she's pregnant, and if she cheated, that too.