Ethics & Law · patient case with 2 questions
Patient who posts a damaging online review
Patient: Adult male, former patient of record
Chief complaint: Rejected the proposed treatment plan.
Background: Became combative during the discussion and left the practice.
Current findings: He has since posted a highly negative public review naming the practice and its staff.
Question 1
How should you respond?
Show answer and explanation
Correct answer: B. Proceed in accordance with the ADA Code of Ethics
- A. This is the most tempting and the most dangerous option. Publicly stating clinical facts to defend yourself is a clear HIPAA breach, and practices have been fined substantially for exactly this.
- B. CORRECT. The governing constraint is CONFIDENTIALITY. Responding publicly, or pressuring the patient, risks disclosing protected health information — even confirming that someone is a patient is a HIPAA disclosure. The correct course is to follow the professional code: respond, if at all, in generic terms that acknowledge the concern and invite private contact, without confirming any clinical detail.
- C. Pressuring a patient to retract is coercive and unprofessional, and invites escalation.
- D. A demand letter is equally coercive and carries legal exposure.
Note: The examinable point: your obligation of confidentiality does not lapse because the patient waived their own privacy publicly.
Question 2
Which ethical principle most directly underlies the confidentiality obligation here?
Show answer and explanation
Correct answer: A. Autonomy
- A. CORRECT. AUTONOMY encompasses the patient's right to self-determination, which includes control over their own health information. Confidentiality and informed consent both derive from it.
- B. Justice concerns fairness in the distribution of care and resources.
- C. Non-maleficence is the duty to do no harm.
- D. Beneficence is the duty to act for the patient's benefit.