Case One Mary Stokes is in need of a kidney transplant, and her parents and siblings have been tested for compatibility. Her father is afraid of operations and knows that kidney trouble runs in the family. Before the test, Mary’s father tells the doctor that he does not want anyone, especially his wife, to know that he is compatible. He explains that if the family knows they will pressure him into being a donor. The father turns out to be the only one who is compatible. Mary asks the doctor, “Are you sure no one in my family is compatible?”

In each case, answer the questions at the end of the case and give researched references to support your assertions; also, explain what would be the ethical course of action and the legal requirements for action in the case.

Case One

Mary Stokes is in need of a kidney transplant, and her parents and siblings have been tested for compatibility. Her father is afraid of operations and knows that kidney trouble runs in the family. Before the test, Mary’s father tells the doctor that he does not want anyone, especially his wife, to know that he is compatible. He explains that if the family knows they will pressure him into being a donor. The father turns out to be the only one who is compatible. Mary asks the doctor, “Are you sure no one in my family is compatible?”

Is the father a patient and protected by confidentiality? Even if he is not a patient, is his explicit request, which was not refused, a protection of his confidentiality? If the matter is confidential, what can the physician say or do to protect the secret?

Case Two

Dr. Curious has a habit of wandering around the hospital and looking at the records of friends who are in the hospital. The nurses have tried to stop him, but he has retaliated by making their lives miserable and belittling them in public at every opportunity. The nursing administration has been notified but has done nothing, as it wants to avoid rocking the boat.

What are the nurses’ ethical obligations after they have done everything mentioned in the text? See Chapter 2 (Garrett). Is “not wanting to rock the boat” a sufficient excuse for the administration to do nothing further?

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