Under what circumstances must a physician override confidentiality?

The physician's obligation to maintain patient confidentiality is a fundamental principle in medical ethics and law. However, there are specific circumstances under which a physician may override this confidentiality to protect individuals or the public.

When there is a real threat of harm to third parties, the physician is justified in breaching confidentiality. This is typically guided by laws and ethical standards that prioritize the safety of others over a patient's privacy. For instance, if a patient expresses intentions or threats to harm another individual or themselves, or if there is a communicable disease that poses a risk to others, the physician has a responsibility to intervene. This could include notifying the potential victim or public health authorities.

In contrast, confidentiality should not be overridden merely based on any patient request, age of the patient, or general intentions to improve treatment outcomes, as these factors do not demonstrate an imminent risk of harm. The principle of protecting third parties when a clear and immediate threat exists is critical in ensuring that the physician fulfills their ethical duties while balancing patient confidentiality.