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Do French lay people and health professionals find it acceptable to breach confidentiality to protect a patient’s wife from a sexually transmitted disease?
  1. M Guedj1,
  2. M T Muñoz Sastre1,
  3. E Mullet2,
  4. P C Sorum3
  1. 1CERPP, Université du Mirail, Toulouse, France
  2. 2Ecole Pratique des Hautes Etudes, Paris, France
  3. 3Departments of Medicine and Pediatrics, Albany Medical College, Albany, New York, USA
  1. Correspondence to:
 Dr Sorum
 Latham Med-Ped, 724 Watervliet-Shaker Road, Latham, NY 12110, USA; sorump{at}mail.amc.edu

Abstract

Objective: To determine under what conditions lay people and health professionals find it acceptable for a physician to breach confidentiality to protect the wife of a patient with a sexually transmitted disease (STD).

Methods: In a study in France, breaching confidentiality in 48 scenarios were accepted by 144 lay people, 10 psychologists and 7 physicians. The scenarios were all possible combinations of five factors: severity of the disease (severe, lethal); time taken to discuss this with (little time, much time); intent to inform the spouse about the disease (none, one of these days, immediately); intent to adopt protective behaviours (no intent, intent); and decision to consult an expert in STDs (yes, no), 2×2×3×2×2. The importance and interactions of each factor were determined, at the group level, by performing analyses of variance and constructing graphs.

Results: The concept of breaching confidentiality to protect a wife from her husband’s STD was favoured much more by lay people and psychologists than by physicians (mean ratings 11.76, 9.28 and 2.90, respectively, on a scale of 0–22). The patient’s stated intentions to protect his wife and to inform her of the disease had the greatest impact on acceptability. A cluster analysis showed groups of lay participants who found breaching confidentiality “always acceptable” (n = 14), “depending on the many circumstances” (n = 87), requiring “consultation with an expert” (n = 30) and “never acceptable (n = 13)”.

Conclusions: Most people in France are influenced by situational factors when deciding if a physician should breach confidentiality to protect the spouse of a patient infected with STD.

  • STD, sexually transmitted disease

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