A 76 year old man with end-stage cancer is admitted to your ward. He’s calm, aware of his prognosis, and tells you quietly:
“Please don’t tell my family how bad it really is. I want them to think I’m going to be fine.”
But the next morning, his daughter asks you,
“Doctor, tell me honestly… how long does he have?”
You’re caught. The patient has asked for confidentiality. The family wants transparency.
Both trust you.
So here’s the dilemma:
As a doctor, who do you owe more - the patient’s autonomy, or the family’s right to prepare?
As a doctor, my primary duty is to respect the patient’s autonomy and confidentiality. While I understand the family’s need to prepare, I must honor the patient’s wishes unless he permits me to share.
In our curriculum there is AETCOM that tells about ethics and communication.
So to be very honest…tell the family but all the this things that patient don’t want to tell you so don’t discuss with each other anything…
This will be actually solution of this problem.
In medicine, the patient’s autonomy comes first confidentiality is a core ethical duty.
While families deserve compassion and support, we can’t override a competent patient’s wishes. The real challenge lies in guiding both sides with honesty, empathy, and respect.
Balancing patient autonomy and family concern requires empathy and effective communication. We can counsel the patient and provide general guidance to family can help.
In medical ethics there are 4 key principles : Autonomy , Beneficence , Non - malificence and Justice. According to that , patient’s right to autonomy and confidentiality take over family’s right to know. We can encourage the patient to allow disclosure to certain things for the family’s sake.
This way respects both the patients rights as well as family’s emotional needs