Behavioral Science & Ethics USMLE Step 1 Practice Question
A 19-year-old male college student with cystic fibrosis presents to his pulmonologist with a 2-week history of productive cough, fever, and dyspnea. Spirometry shows FEV1 of 62% predicted. The patient is emancipated, financially independent, and lives on campus. He explicitly requests that his diagnosis and clinical status not be disclosed to his parents, stating he wants to manage his own healthcare decisions. He denies depression, suicidal ideation, or acute psychiatric symptoms. The next day, his mother calls the clinic requesting detailed information about her son's current condition and treatment plan, citing her involvement in his healthcare throughout childhood. The physician has documented the patient's confidentiality request in the medical record. Which of the following actions is most appropriate?
Answer choices
- ADecline to share any information with the parents without the patient's written authorizationCorrect answer
- BProvide general confirmation that the patient was seen but defer specific clinical details to the patient himself
- CShare detailed clinical information with the parents to facilitate coordinated care of a serious chronic condition
- DProvide summary information about lung function given the significant reduction in FEV1 and risk of clinical deterioration
- EConsult the hospital ethics committee to determine whether parental notification overrides patient confidentiality in severe disease
- FRequest that the patient sign a HIPAA release form before the parents contact again to preempt future calls
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