Moral Dilemmas and Realistic Vision in the Field of Health with regard to Confidentiality

Secrecy or confidentiality has always been considered a crucial issue in the medical profession. Secrecy is a common and essential principle among patients and physicians، and is highly emphasized in professional ethical codes and guidelines. This case report is based on an actual case in Medical Ethics Grand Rounds in Tehran Children''s Medical Center، with a glance at the boundaries and challenges of keeping and revealing the secrets of the patients. Case Scenario: In this report، a neonate with withdrawal symptoms was admitted to the hospital. After routine examinations by the medical team، they found the neonate’s mother was addicted and had concealed her addiction from her husband and her family. To facilitate treatment of the infant، they discussed the matter with the mother in order to get accurate information. The mother’s denial on one hand، and the need for accurate and comprehensive information necessary to begin treatment on the other caused a challenge to keeping or disclosing the mother’s secret. Here the medical team assumes responsibility to obtain the information from the mother، convince her and win her cooperation، and finally share the secret with the spouse to help their ill neonate. Although respect for patients’ confidentiality is an imperative issue for physicians and healthcare workers، it is not an unequivocal requirement. Due to logical and religious reasons and based on each specific case، it is necessary to make decisions that are more reasonable and less harmful to the patients and their families. Naturally the staff is required to keep the secrets of their patients permanently.