Ethics and Medicine?

Question

This question recently popped up in one of my classes and it really got me wondering. Here is a married couple that has been married for 12 years. Say you are a doctor and you have to test thier new born child for some sort of genetic disorder. Upon doing so, you discover that the child is not the father's. Do you inform the father or speak to the wife about the child not being his, or do you just give them the results of the test? Say it being a genetic disorder they were testing for and the child did have it but neither of the married couple had it, what would you say then?

Just to be clear, obviously, I would report the medical condition. My question is more regarding the adultry aspect.

Answer 1

Of course you have to spill the beans, the child's life is in your hands and to pass it off as a perfectly healthy baby just to maintain their already ruined relationship is malpractice.

Answer 2

Luckily, this is not and can never be a conundrum. When one applies a specific genetic test to look for a disease, the test results reveal only the presence or absence of that disease. They do not reveal any other information. Paternity would not be revealed unless one of the parents specifically ordered a paternity test. There can be no "accidental" discovery of non-paternity. Even if something really weird happened and the doctor had an opportunity to suspect non-paternity, he would never divulge his suspicions in the absence of an authentic paternity test. Doctors are not trained geneticists, and they would really hate to be sued if they came to a capricious conclusion incorrectly.

But just so you know, non-paternity in the United States runs at about 10%. That means that 10% of us have a father who is not the man listed on our birth certificates. There have been a tremendous number of studies that have examined this phenomenon, and this number, 10%, has been shown to be constant among all races and socio-economic classes.

Answer 3

If the child has the disorder, there is really no way for you to disclose this to the parents without discussing the paternity question with at least one of them, because they will ask--who passed it to the child?

In this case, I would inform the mother of the results and tell her that the tests showed that husband is not the father. She can then decide how to pass this information to her husband. If the husband then comes calling, you can tell him that his wife has received the results and that if he has any questions after speaking with her, he may call again.

Answer 4

I should imagine it would be important to contact the natural father in this case. Don't want him impregnating any other unsuspecting souls, do we? Given that, I think it is necessary to discuss the issue with the parents. That would be a pretty crappy thing to have to do. Glad I don't have that responsibility.

Answer 5

Honesty is the best policy.

('white lies' or ignoring the facts can be tempting but in the long run only serve to complicate things and make matters worse. A doctor has to be careful but in the end he or she is a scientist and has a duty to report the facts the way they are without 'judging' them)

Answer 6

What about patient confidentiality? I don't think it would be your right to tell the father. You should ask the mother about it and let her decide if she tells the father. It is not your responsibility unless the mother wants you to tell the father for her.