Case Studies
This section presents hypothetical and analytical case studies designed to explore clinical reasoning through a biological lens. Each case focuses on understanding symptoms, underlying biological mechanisms, and relevant systems rather than diagnosis or treatment.
The goal of these case studies is to practice structured thinking, connect biological concepts to clinical presentation, and examine how evidence and reasoning guide medical understanding. All cases are educational in nature and do not represent real patients or medical advice.
Case Study: Patient Confidentiality vs. Duty to Protect
Source: Adapted from a case scenario shared by u/Every_Gap7429 on r/Doctor (Reddit)
This case really made me stop and think about what it actually means to be responsible for someone’s life, not just medically, but ethically.In this scenario, a pregnant patient comes in for routine testing. During the process, it becomes clear that her husband is HIV positive. When questioned privately, he initially denies any possible exposure, but after further discussion, he admits to having had multiple sexual partners several years ago. The problem is that he refuses to tell his wife about his diagnosis, even though she is pregnant and potentially at risk. He explicitly asks the doctor not to disclose this information to her.This puts the physician in a position where every option feels wrong.
On one hand, patient confidentiality is one of the most fundamental principles in medicine. Trust is the reason patients are honest with doctors in the first place. If confidentiality is broken too easily, that trust collapses, and people may avoid seeking care altogether. The husband did not consent to having his diagnosis shared, and violating that privacy could have serious legal and ethical consequences.
On the other hand, the pregnant patient is also the doctor’s responsibility. She is unknowingly being placed at risk for HIV, and so is her unborn child. Preventing harm is just as central to medicine as respecting autonomy. Allowing someone to remain unaware of a serious, preventable danger feels like neglect, even if it technically follows the rules.What makes this case especially difficult is that it’s not just about two adults. There is also a fetus involved, someone who cannot advocate for themselves. HIV transmission during pregnancy can often be reduced or prevented with early intervention, but that only works if the patient knows the risk exists. Silence, in this case, could directly lead to harm.
Personally, I find this case highlights the tension between confidentiality and duty to protect. While confidentiality is critical, I don’t think it should ever outweigh preventing serious harm to another person, especially when that harm is foreseeable and avoidable. Many ethical frameworks argue that when a third party is at clear risk, disclosure can be justified, even without consent.This case made me realize that medicine isn’t about following rules blindly. It’s about judgment, responsibility, and sometimes choosing the least harmful option when no choice is perfect. Situations like this are exactly why ethical reasoning is just as important as scientific knowledge in medicine.
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More to come soon!