Keeping Medical Information a Secret

Debbie Elliott and New York Times Magazine ethicist Randy Cohen answer a listener's ethical dilemma about whether to alert others to a patient's medical condition.

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DEBBIE ELLIOTT, host:

If you suspect someone might have a medical problem, should you speak up? That's our question this week for The Ethicist. Randy Cohen writes The Ethicist column in the New York Times magazine and joins us from time to time to solve your ethical dilemmas. Hi, Randy.

Mr. RANDY COHEN (Writer, New York Times): Hi, Debbie.

ELLIOTT: Our letter today comes from Eunice Hyu(ph), a college student in Ann Arbor, Michigan. She thinks she may have missed an opportunity to help someone who might be very sick.

Ms. EUNICE HYU (College Student): This summer I volunteered at a small hospital and I had the privilege of running EKGs on patients who were prepping for other work, and this involves them taking their shirts off and then I would place electrodes on their chest. One day, a woman came in and her breasts were obviously very wrinkled and puckered. She was pretty young, about forty years old, and to me, this was a sign of breast cancer, just from anecdotal reports that I'd read. I think I know that it's pretty advanced stage breast cancer when you can see it. And I'd also read that it's also possible that people will be in denial about what is plainly evident on their bodies and may not know what...

ELLIOTT: May not realize how serious it is.

Ms. HYU: Right. Right. And so this hospital was in a Chinatown and I couldn't speak Chinese, Mandarin or Cantonese well enough to remember how to say breast cancer or really have a conversation with her. I felt very uncomfortable and I didn't know how to bring it up to her, so I did the EKG and I watched her leave and I wondered whether it was my responsibility, this being a medical opportunity to have brought it up with her.

ELLIOTT: Now, you're just a volunteer at the hospital, you're not a doctor or a nurse or a medical student?

Ms. HYU: That's right, I'm a college student volunteering.

ELLIOTT: Did you ever think about maybe, you know, asking a doctor to follow up with the woman? Did you know who her doctor was?

Ms. HYU: I didn't, although she had a card and I could have looked at the card and found out who her doctor was.

ELLIOTT: Randy, what do you think? Eunice is not a doctor.

Mr. COHEN: And even if she were a doctor, I'm not so sure it would have been her task to speak directly to the patient. I think what you were both hinting at was the right thing to do, is find out who the primary care physician is. That's the person who has, first, the training to asses this, and second, the experience to put them in some kind of perspective. But equally important, her primary care physician is the person that has the relationship with the patient and can best break this kind of news to them. I get variations on this question a lot, that if you have medical training and you notice someone on the street who might have something wrong with them, when do you approach a stranger, a sort of variation on your question.

They'll see a pregnant woman drinking or smoking. Should I say something? And in my opinion, no, you don't approach strangers to tell them something they already know. You know, this woman knows she's smoking, that woman knows she's drinking, the big fat guy knows he's a big fat guy eating donuts, that's being not a good Samaritan, but a busybody.

But if you know something about a person, as in your case, that they might not know themselves, like if you saw someone who's hat was smoking, you know, their hat might on fire, then you should tactfully suggest that they, you know, see their doctor or call the fire department.

ELLIOTT: Eunice Hyu, thanks for writing to The Ethicist.

Ms. HYU: Thanks so much.

ELLIOTT: If you want Randy Cohen to shoulder some of your burdens, write to us at WATC at NPR.org. Put the word ethics in the subject line and please be sure to include a phone number where we can reach you. Randy, thanks again.

Mr. COHEN: Thank you, Debbie.

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