GP Stage 3 Simulated Consultation - Relative 11
You are an SHO in GUM & Sexual health. Julian May, the partner of one of your patients recently diagnosed with Chlamydia has requested to speak to you.
You are Julian May, the partner of Kerry. You found a ‘contact card’ for the Gum & Sexual Health centre in Kerry’s pocket and as such you suspect that Kerry may have attended the clinic for a sexual health screen. You would like to know if Kerry has been diagnosed with an STI (sexually transmitted infection) and the resultant risk to you. If advised that this information cannot be shared, you become upset proclaiming that you have a young child to look after, and as such it is essential that you are informed about any infections that you may have. You are also keen to establish if Kerry has been cheating on you, as you note that Kerry has been coming home from work later than usual for the last couple of weeks.
You have not discussed your concerns directly with Kerry and you would prefer not to, if your fears are misguided as this would lead to an unnecessary argument. However, if the doctor were to advise you regarding the result, this would allow you to be treated if required and approach Kerry appropriately. Your expectation is that the doctor should be able to provide you with the results and information, given that you are also a patient and the fact that sexually transmitted infections are easily transmitted and potentially life threatening.
At home, you live with Kerry and your two year old son. You are having protected sexual intercourse with Kerry, and do not have any symptoms or additional concerns.
This is a challenging case which requires some knowledge of the GMC Guidelines on confidentiality. The guidelines state that there are specific criteria and protocols through which confidentiality can be breached in cases of ‘serious communicable diseases’; these are defined as diseases that can be transmitted from human to human and result in death with the primary examples given being HIV, Tuberculosis, Hepatitis B & Hepatitis C. Whilst Chlamydia can cause medical morbidity, the general consensus is that it is not considered a serious communicable disease for which confidentiality can be breached. Additionally, it is important reassuring to note that the couple are not having unprotected intercourse. Alternative solutions include recommending that Julian has a sexual health screen to address underlying concerns, or discuss the matter with Kerry should this be possible. Empathetic support and exploration of wider concerns is important in making Julian feel supported and listened to.