Welcome to English as a Second Language podcast number 662, Doctor-Patient Confidentiality.
This is English as a Second Language podcast episode 662.
I'm your host, Dr Jeff McQuillan, coming to you from the Center for Educational Development in beautiful Los Angeles, California.
Our website is eslpod.com.
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On this episode we're going to have a conversation between two doctors who who are talking about confidentiality, keeping things private or secret between a doctor and his or her patient.
Let's get started.
Can I consult you on a case of medical ethics?
Sure.
I'm not a lawyer, but I can give you my opinion as another doctor.
That's what I'm looking for, your honest opinion.
I have a patient who has a medical condition that can be spread to her family, but she doesn't want to tell them about it.
I don't want to breach doctor-patient confidentiality, but I think that at least her husband should know.
That's a tricky one.
We both know that the only way we can get our patients to divulge any sensitive information is if they trust us.
We can't easily put aside that confidentiality.
I know, but if she doesn't tell her family then they are in danger of developing serious medical problems themselves.
I took the Hippocratic oath to do no harm.
How can I keep her secret and adhere to the spirit of that oath?
I see what you mean.
If I were you, I'd sit my patient down and tell her what you think her responsibilities are to her family.
Maybe you can convince her to tell them.
I've tried talking to her already and she didn't want to listen.
I'll try again, but what if she doesn't agree?
Then you can either drop it, tell her family, or... Or what?
Hope your patient has a miraculous recovery.
We begin with Dr. Green asking Dr. House a question.
He says, can I consult you on a case of medical ethics?
To consult means to talk to someone, often a person who's an expert or who may know more than you do, and ask them for their advice.
Ask them what they would do in this situation.
A person who gets paid to give their opinions and advice or to do some work for a company is called a consultant, with an A-N-T at the end of the word.
Dr Green wants to consult Dr House on a case or a situation.
An example Ethics E-T-H-I-C-S are the ideas and standards about what type of behavior is right or wrong.
We might say ethically or morally right or wrong.
Medical ethics refers to the decisions that doctors may make regarding their patients, whether they are right or wrong.
The patient is.
You probably know the person who is getting or receiving medical treatment, medical care.
It's the person who's sick.
Dr. House says, sure, you can consult me.
I'm not a lawyer.
An attorney, someone who knows a lot about the law and who charges you a lot of money to get that information.
But, she says, I can give you my opinion as another doctor.
Dr. Green says, that's what I'm looking for.
That's what I want, your honest opinion.
I have a patient who has a medical condition that can be spread to her family.
We explain patient as the person who is sick.
To spread to something or somewhere means to expand or to affect a larger group of people or to have a greater impact.
Normally we talk about diseases that spread from one person to another.
Diseases that are contagious, that is, you can get the disease from someone else.
The disease that Dr Green's patient has can be spread to her family, but this patient doesn't want to tell her family about it.
Dr Green says.
I don't want to breach doctor-patient confidentiality, but I think that at least her husband should know.
To breach, B-R-E-A-C-H, here means to break a promise, not to do something.
What you promised to do, to break a rule.
In this case, the doctor would be breaching doctor-patient confidentiality.
Confidentiality is the agreement between, or the promise that a doctor gives his or her patient that they will not tell anyone else about their medical condition at least no one who is not also working with the doctor as a medical expert.
In the recognized in law, that is, a doctor has a confidential relationship with his or her patient and cannot be forced to tell the police, for example, about information that is private with that patient.
A lawyer has similar confidentiality with his or her clients, the people who pay them to do legal work for them.
Dr Green is worried.
This woman has a disease that she is going to spread to her family, but he doesn't want to break his promise to breach that confidentiality.
To breach, I should mention, has some other meanings.
Take a look at our learning guide for some additional explanations.
Dr. House says that's a tricky one.
A tricky T-R-I-C-K-Y.
One is a difficult problem or a difficult situation, something that is very complicated.
Someone may say, well, it's kind of tricky.
They mean it's complicated, it's complex, it's difficult.
There is no obvious solution.
That's how Dr. House describes Dr. Green's problem.
She says...
Divulge, D-I-V-U-L-G-E, means to tell someone a secret.
To share a secret, often one that you are not supposed to share or tell someone else.
Sensitive information is personal or private information, things about your health, your family and so forth.
To trust means to rely on, to count on, To be able to say yes, this is someone I have confidence in.
They won't hurt me.
They won't break their promise.
I trust them.
I believe them.
Dr House says that the only way a doctor can get his or her patients to divulge, to tell any sensitive information to them is if the patients trust the doctors.
She says we can't easily put aside that confidentiality.
To put aside A-S-I-D-E something or to put something aside is a two-word phrasal verb meaning to not consider or not follow some rule or some principle.
To stop considering something as a factor is also another way of using this verb.
I'm going to put aside all of the arguments that I have had with my neighbor in order to help him with his car.
I'm going to help him fix his car.
Unfortunately, I don't know anything about repairing cars, but, well, I'll do my best.
I'm going to put aside our problems, our arguments.
I'm going to say, okay, they don't exist for now, temporarily.
Dr House thinks that you cannot put aside doctor-patient confidentiality just because you have a difficult situation.
Dr Green says I know, but if she, his patient, doesn't tell her family, they are in danger of developing serious medical problems themselves.
They could get sick.
He says, I took the Hippocratic oath to do no harm.
The Hippocratic oath, named for the famous Greek doctor Hippocrates, is a promise made, or at least used to be made, by doctors when they begin their medical career, when they begin working as doctors, saying that they will obey, they will follow certain ethical rules and regulations.
That isn't true anymore, at least in the United States, but or at least doctors no longer say the original Hippocratic Oath.
If they say it, it's been changed.
The oath, any oath, is a promise, an official promise.
So Dr. Green says he took the Hippocratic Oath to do no harm.
That's a phrase that's in the original oath.
To do no harm means don't do anything that will hurt another person or another situation.
The first thing a doctor should do is not make the patient sicker, not make things worse.
That's the idea of doing no harm or injury.
Dr. Green says, how can I keep her secret and adhere to the spirit of that oath?
To adhere A-D-H-E-R-E to something means to follow the rule, to follow some regulation, to do what it says.
The spirit of something is the idea behind something, the general philosophy behind a certain rule.
So it is sort of more than the rule.
It is the intention or idea of this rule.
Dr. Howe says, I see what you mean.
I understand what you're saying.
If I were you...
To sit someone down means to have a serious conversation with someone about something that requires their complete attention, something that is very serious and important.
Dr. Green says, I've tried sitting my patient down.
I've tried talking to her already, and she doesn't want to listen.
I'll try again.
But what if she doesn't agree?
What if she does not change her mind?
Dr. House says, then you can either drop it, tell her family, or Dr. Green says, or what?
Dr. House says, hope your patient has a miraculous recovery.
To drop it means to forget about something, usually because it's too difficult or too uncomfortable.
It's an informal phrase, to drop it, often used in the command form.
If your wife is arguing with you, she may say eventually, oh, let's just drop it or drop it, okay?
Meaning, stop talking about it, stop thinking about it.
You're trying to change the subject.
You're trying to move on to something new.
In this case Dr House tells Dr Green that he can either drop it, meaning forget about this problem, tell the patient's family or hope the patient has a miraculous recovery.
A recovery is when a person, a sick person, gets better.
They start to feel more healthy.
That's a recovery.
Recovery has a number of different meanings, none of which are explained in the learning guide.
However, the word drop has meanings that are explained in the learning guide.
Miraculous is something that is outside the ordinary, something that has no scientific explanation.
Something that is miraculous is something that seems to be unnatural in some ways.
It's something that doesn't follow the usual laws of, we might say, of nature, of the way the world is supposed to work, the physical world.
Now let's listen to the dialogue, this time at a normal speed.
Can I consult you on a case of medical ethics?
Sure.
I'm not a lawyer, but I can give you my opinion as another doctor.
That's what I'm looking for, your honest opinion.
I have a patient who has a medical condition that can be spread to her family, but she doesn't want to tell them about it.
I don't want to breach doctor-patient confidentiality, but I think that at least her husband should know.
That's a tricky one.
We both know that the only way we can get our patients to divulge any sensitive information is if they trust us.
We can't easily put aside that confidentiality.
I know, but if she doesn't tell her family then they are in danger of developing serious medical problems themselves.
I took the Hippocratic Oath to do no harm.
How can I keep her secret and adhere to the spirit of that oath?
I see what you mean.
If I were you, I'd sit my patient down and tell her what you think her responsibilities are to her family.
Maybe you can convince her to tell them.
I've tried talking to her already, and she didn't want to listen.
I'll try again.
But what if she doesn't agree?
Then you can either drop it, tell her family, or... Or what?
Hope your patient has a miraculous recovery.
When our scriptwriter tells us that she is going to write a great script for us, we trust her.
Why?
Because it's the one, the only...
Dr. Lucy Say.
From Los Angeles, California, I'm Jeff McQuillan.
Thank you for listening.
Come back and listen to us again on ESL Podcast.
English as a Second Language Podcast is written and produced by Dr Lucy Say, hosted by Dr Jeff McQuillan.
Copyright 2011 by the Center for Educational Development.
