The Dilemma of Speaking Up or Keeping Quiet

12 Apr

Doctor’s and other physicians make difficult decisions everyday. Decisions like choosing the right medicine to treat a patient and the most important being respecting the rule of patient confidentiality. This past year, a pediatric nurse practitioner, Trish McDade, faced one of the toughest dilemmas.

“I was treating an 18 year old girl who had mentioned to me during the visit that she was being harassed in school. Now, immediately I thought she was being sexually abused, but the girl said she wasn’t she was just being picked on and teased,” said McDade.

A person being harassed in any kind of way is definitely not a good thing. Nowadays, kids in any grade decide that it is okay to pick on somebody and that can really cause harm. The problem with kids and young adults being picked on results in them not telling their parents or confiding in anyone else because they are afraid.

“I asked her if she thought this harassment would go to the next level of sexual harassment and she said maybe. Then, I asked the most important question of is she told her parents or not, and she said no,” said McDade.

According to McDade, this ended up being her biggest concern because in a case like this parents should know if their child is being harmed or in any other danger. She said she knew she wasn’t allowed to say anything because the child was 18 and because of patient confidentiality, so she felt really at a loss.

“I had no idea what to do, I was caught between an oath I took as a physician to keep my patient’s information private, but I also knew that it would be wrong to keep that from her parents,” said McDade.

As a physician, the best bet in this kind of case would be to encourage the patient to tell their parents about what is going on. According to McDade, this is exactly what she tried to do, but the patient refused because she didn’t want her parents getting involved with the school because she thought the harassment would get worse.

“When the patient told me she thought the harassment would get worse because of this, I was even more concerned and at that point I knew what I had to do, and that was to tell the parents,” said McDade.

McDade decided to tell the parents because she felt it was in the best interest of her patient and with a case as serious as harassment, she couldn’t let that go unknown by the patient’s parents. While she did break confidentiality and the opportunity for the young adult to speak up, she didn’t feel right letting the patient walk out without saying anything.

If I were in this position, I think I definitely would have done the same thing. Sometimes you have to look at the bigger picture and beyond the rules that someone’s life was in danger and you needed to speak up about it. Harassment is no joke, and if I had the chance to get that patient some help before the worst happened, then I would definitely take that chance.

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