title: Limits of confidentiality: to disclose or not to disclose.
abstract: A patient who sustained a gunshot wound to a femoral artery you repaired yesterday is doing well and is very grateful. He is a security guard who got involved in a gunfight with criminals and is chatty. He recently had a strong analgesia injection, relaxing inhibitions and loosening his tongue. He asks if what he tells you is strictly confidential and you reply yes, it is. He remarks on how lucky he is now and years before. It seems, when young, he killed a man over a drug deal gone badly. He ascribes his luck to the fact that another man was convicted and is spending life in the "big house." What should you do?
authors.affiliation: Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA. jwjones@bcm.tmc.edu
authors.forename: James W
authors.initials: JW
authors.lastname: Jones
authors.forename: Laurence B
authors.initials: LB
authors.lastname: McCullough
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D003142:Communication; D008192:Deception; D006708:Homicide / Q000941:ethics* / Q000331:legislation & jurisprudence; D006801:Humans; D007266:Inhibition, Psychological; D028681:Moral Obligations; D010817:Physician-Patient Relations / Q000941:ethics*; D012941:Social Responsibility; D014342:Truth Disclosure / Q000941:ethics*
chemical_list: D000700:Analgesics