Category Ethics

When a patient wants their cake and wants to eat it too

When a patient wants their cake and wants to eat it too

Samuel Vorster

Introduction: The dilemma:

A male patient of 38 years, alcohol dependent, currently working as a pilot, for a airline in Southern Africa, asks you to help him with his problem. He also asks of you to keep his diagnosis confidential, as he would immediately lose his job should his diagnosis be made known.  This ethical dilemma involves a value dispute1, where the patient sees his medical condition and the possible effects, for his work, as being separate.

The patient has an alcohol dependency. It has known effects and concerns.  There is a concern with the patient’s ability to conduct his work whilst in the intoxication and withdrawal symptoms of his use.  There is a risk of harm to others, property and to himself.

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