Everyday patients place their trust in the hands of their doctors. Maintaining confidentiality ensures quality care by showing that patients can rely on physicians to cherish the bond of trust between the patient and doctors, and maintain privacy. When breaching confidentiality, professionals will need to make judgments about the significance of the information to both patients. The right to Helen’s confidentiality should be protected because the potential harm caused by breeching her confidentiality outweighs the potential benefits of Penelope being informed.
Helen has a 4 year old son that has been diagnosed with Duchenne Muscular Dystrophy (DMD), which is an x-recessive genetic condition that is carried by girls but with very rare exceptions boys are affected. Helen is a carrier for the mutation, but it is said that only half of the women carriers’ sons will inherit it from them and will be affected. Helen has a sister, Penelope that is 10 weeks pregnant and is worried that her fetus may have the genetic problem. However, there is a one in four chance that a female will inherit the gene and become a carrier. Helen is aware her sister is pregnant and she feels if she tells her sister of her and her son’s diagnosis, Penelope would likely terminate the baby. Helen speaks to her medical providers and decides she wants the results to remain confidential and not be disclosed to her sister.
Although it might seem morally right for Helen to share her medical information with her sister, she is not obligated to share her carrier status because she is entitled to that information. In bioethics, respect for patient autonomy is an essential requirement when considering the principle of autonomy, in that “...persons should be allowed to exercise their capacity for self-determination” (Vaughn, 71). Being an autonomous adult, Helen has the right to privacy, in which she controls the disclosure of confidential information about herself and her son. Although Penelope’s respect for autonomy is at risk for being diminished, the clinicians and counselors must consider their obligation to keep Helen’s pertinent information guarded unless she gives disclosure.
When considering Penelope and her fetus’ well-being, I think it would be feasible for her to know about her carrier status to help promote their quality of life. However, it isn’t morally right to for physicians to disclose that information about her sister being that she is a third party and is in no serious harm. Furthermore, the clinicians would disagree with the idea of disclosing Helen’s confidentiality because there is a small amount of benefit to Penelope because the likelihood of her being a carrier is low, and the anxiety caused to Penelope is likely to outweigh the benefits of being told. Also, the likelihood of her fetus being diagnosed is unknown because she does not know the sex of the fetus; even if it were a boy, there is only a 25% chance that the fetus would be diagnosed with the genetic disorder.
When all the issues have been considered, a decision to breach Helen’s confidentiality might be agreed amongst a group of suitably qualified professionals when the knowledge is of significant potential benefit to Penelope. In a classic case file entitled, “Carlos R” Vaughn contends that physicians have a duty to warn if there is “an imminent threat of serious and irreversible harm, no other way to avert that threat except by breeching confidentiality, and a situation in which the harm done by the breech is on par with the harm avoided by the breech” (Vaughn, 137). Given the factors of duty to warn, it is apparent that physicians don’t have a justifiable reason to breech Helen’s confidentiality.
Physicians can cause potential harm by breeching Helen’s confidentiality. Once Helen’s information has been disclosed, the once confidential information cannot be taken back resulting in trust between her and her physician being diminished. Not only would Helen’s respect for autonomy be violated but so will the ethical principle of nonmaleficence. Undermining trust in a physician and patient relationship is promoting more harm. In addition to potential harm, consideration must be given to the damage done to the counselor’s relationship with Helen, her trust in other doctors in the future, and public perception of the trustworthiness of geneticists could be diminished. Respecting autonomy is important to promote rational decision making, right to privacy, and respectable relationships with medical provider but Penelope is not in a position for us to breach Helen’s confidentiality. Therefore, respect of autonomy is not appropriate in the case of Penelope because there is no serious harm. Although Penelope’s autonomy has to be overridden, we ought to act to promote beneficence and nonmaleficence in the case of Helen and her son.

Works Cited
Vaughn, Lewis. Bioethics: Principles, Issues, and Cases. New York: Oxford UP, 2013. Print.