EthicsAdvancedMMI station
Genetic testing shows the husband isn't the father. The wife begs you not to tell him. Then he asks you if anything came back abnormal. What do you say?
Ethical dilemma: Competing duties with no perfect answer: consent, confidentiality, fairness.
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Sample answer outline
- Clarify the facts: who ordered the test, for what clinical question, and whose information this is.
- Answer his actual question truthfully: report the results relevant to the child's health. Non-paternity was an incidental finding, not what the test was for.
- Don't lie, and don't disclose what isn't yours to share. You can say you will go over the medical findings with both parents.
- Speak with the wife privately: understand her fears, check her safety, encourage her to consider disclosure, offer counseling.
- Involve genetics colleagues and ethics, and follow local law and policy, which vary.
What makes it work
- It separates honesty from full disclosure, which is the heart of the dilemma.
- It keeps the child's medical interests in view.
Avoid
- Telling the husband outright, or lying to him.
- Treating it as a simple yes or no.
How to approach ethical dilemma questions
- Clarify the facts and what you would want to know before acting.
- Name who is affected and the principles in tension: autonomy, doing good, avoiding harm, fairness, confidentiality.
- Walk through realistic options, starting with the least drastic.
- Choose a course of action, explain why, and say who you would involve.
What it tests
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