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Ethical Scenario 11
You are a fifth year medical student on a paediatric rotation. After the ward round, one of your long-term patients (Alison, 9 years old) confides in you that Dr Patin (Consultant Paediatrician) touched her inappropriately yesterday. Alison requests that you promise not to tell anyone about your discussion.
Outline what actions you would take in this scenario.
Outline what actions you would take in this scenario.
This is a somewhat challenging scenario which raises potential safeguarding concerns. With patients often more comfortable confiding in medical students, such a case could well be encountered during early clinical exposure:
Average Candidate Response
- I have a duty of confidentiality towards all patients, and hence I would not tell anyone about Alison’s disclosure.
- It is possible that Alison is mistaken (given her age) and it is highly unlikely that the consultant would act in this way.
- I would discuss the accusations with Dr Patin directly; provided that he can provide a reasonable justification, I would not pursue the matter any further.
Excellent Candidate Response
I understand that in possible safeguarding cases where children or vulnerable adults are involved, I have a duty to investigate this further and that duty over-rides my duty of confidentiality. It would be important to explain to Alison that whilst we take confidentiality very seriously, in cases such as this it is important to investigate the matter further to prevent future similar episodes not only towards Alison but also potentially towards other patients.
I would explore the hospital safeguarding policy, and consider discussing my concerns with the safeguarding lead for the hospital. I would also try to establish from Alison if there was anyone else present at the time of the incident, potentially discussing the incident further with them, as well as trying to discreetly establish if any other patients have been similarly affected.
Having not encountered such a case previously, it would likely be beneficial to request advice from my educational/clinical supervisor, in identifying what additional measures need to be taken.
I understand that in possible safeguarding cases where children or vulnerable adults are involved, I have a duty to investigate this further and that duty over-rides my duty of confidentiality. It would be important to explain to Alison that whilst we take confidentiality very seriously, in cases such as this it is important to investigate the matter further to prevent future similar episodes not only towards Alison but also potentially towards other patients.
I would explore the hospital safeguarding policy, and consider discussing my concerns with the safeguarding lead for the hospital. I would also try to establish from Alison if there was anyone else present at the time of the incident, potentially discussing the incident further with them, as well as trying to discreetly establish if any other patients have been similarly affected.
Having not encountered such a case previously, it would likely be beneficial to request advice from my educational/clinical supervisor, in identifying what additional measures need to be taken.