【伦理道德】你认为这个医生的做法对吗？ - Medicalpractice版

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Medicalpractice版 - 【伦理道德】你认为这个医生的做法对吗？

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(共1页)

A*******s
发帖数: 9638

一个ID Doc刚刚诊断一个病人HIV. 这个病人要求他不要告诉他LD。
病人的LD找到这个医生，要求医生告诉她诊断结果，因为她非常担心她会得HIV。
这个医生说，我不能告诉你诊断结果。但我建议你做HIV检查。
在中国， HBV可能更加普遍，好像这种事不是什么大不了的事。
你要是这个医生，会怎么做？

N*G
发帖数: 217

I think what that Doc said is appropriate.

f******w
发帖数: 10267

re。
LD就遇上过同样的情况，当时还是intern，高年级的resident就是这样回答的。美国跟
中国不一样，各种法律保护的是当事人的privacy，即便是夫妻，也不能随便告诉病情。

【在 N*G 的大作中提到】

: I think what that Doc said is appropriate.

L****n
发帖数: 12932

是要保护当事人的privacy, 但起码要告诉性伴侣wear protection, not just check
for HIV.

情。

【在 f******w 的大作中提到】

: re。
: LD就遇上过同样的情况，当时还是intern，高年级的resident就是这样回答的。美国跟
: 中国不一样，各种法律保护的是当事人的privacy，即便是夫妻，也不能随便告诉病情。

f******w
发帖数: 10267

可以旁敲侧击地提醒，比如，Using protection will give you peace of mind。但是
作为医生本人，手脚本来就是被法律困住的。

【在 L****n 的大作中提到】

: 是要保护当事人的privacy, 但起码要告诉性伴侣wear protection, not just check
: for HIV.
:
: 情。

L****n
发帖数: 12932

i would say:"you SHOULD wear protection for your safety" because she is in
life threatening danger.
as long as you don't make statement like "he is HIV positive", i don't think
u'll be liable.

【在 f******w 的大作中提到】

: 可以旁敲侧击地提醒，比如，Using protection will give you peace of mind。但是
: 作为医生本人，手脚本来就是被法律困住的。

N*******r
发帖数: 118

如果这个例子是在美国的话，答案就只有一个:就是那个ID医生的回答。如果是我回答的
话，除了“我不能告诉你诊断结果。但我建议你做HIV检查”之外，还要再加上“建议
你直接问你LD这个问题”。
对医生来讲Patient Confidentiality已经不是医疗问题，而是一个法律问题。
PConfidentiality

【在 A*******s 的大作中提到】

: 一个ID Doc刚刚诊断一个病人HIV. 这个病人要求他不要告诉他LD。
: 病人的LD找到这个医生，要求医生告诉她诊断结果，因为她非常担心她会得HIV。
: 这个医生说，我不能告诉你诊断结果。但我建议你做HIV检查。
: 在中国， HBV可能更加普遍，好像这种事不是什么大不了的事。
: 你要是这个医生，会怎么做？

A*******s
发帖数: 9638

严格的说，这个attending还是有breech of confidentiality. 道德上他可能是对的
，但法律上，他是liable for breech of confidentiality.

A*******s
发帖数: 9638

“但我建议你做HIV检查”间接肯定了LD的疑问，医生是liable的。

答的

【在 N*******r 的大作中提到】

: 如果这个例子是在美国的话，答案就只有一个:就是那个ID医生的回答。如果是我回答的
: 话，除了“我不能告诉你诊断结果。但我建议你做HIV检查”之外，还要再加上“建议
: 你直接问你LD这个问题”。
: 对医生来讲Patient Confidentiality已经不是医疗问题，而是一个法律问题。
: PConfidentiality

L****n
发帖数: 12932

we are all WRONG. just check the law:
***Known partners of an HIV-positive person must be notified that they have
been exposed to HIV by a physician or public health officer.
At least in New York state, but i would think other states have the similar
legislation.

答的

【在 N*******r 的大作中提到】

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A*******s
发帖数: 9638

True, but the HIV patient has to agree. Or the physician is liable.
Public health office is a place the physician should defer to.

have
similar

【在 L****n 的大作中提到】

: we are all WRONG. just check the law:
: ***Known partners of an HIV-positive person must be notified that they have
: been exposed to HIV by a physician or public health officer.
: At least in New York state, but i would think other states have the similar
: legislation.
:
: 答的

L****n
发帖数: 12932

i don't think so. the law is VERY CLEAR on this aspect:
***Under what circumstances can HIV-related information be disclosed without
an approved HIV release form?***
-For medical treatment:
* Medical professionals working on the treatment team with the person's
existing provider may discuss a patient's HIV-related information with each
other or with their supervisors, but only to give necessary care. A general
release is needed to disclose medical information to a provider who is not
affiliated with the person's current medical provider.
* With a general release, a hospital or health care provider may share
HIV-related information with a patient's insurance company if the
information is needed to pay for medical care.
* Medical personnel and certain other supervisory staff may have access
to HIV-related information to provide or monitor services if the person is
in jail or prison or is on parole.
* Disclosure may occur without consent in certain cases of on-the-job
exposure to HIV when all criteria for exposure have been met.
* Parents or guardians of a minor or individuals who are legally
authorized to provide consent can be given HIV-related information about the
person if it is necessary to provide timely care, unless it would not be in
the person's best interests to disclose the information.
-To monitor health care and disease prevention:
* Health care facility staff and committees, oversight review
organizations, or government agencies that are authorized to have access to
medical records may be given HIV-related information when it is needed to
supervise, monitor, or administer a health or social service.
* Known partners of an HIV-positive person must be notified that they
have been exposed to HIV by a physician or public health officer.
* Public health officials may have access to this information when
required by law (such as HIV/AIDS case reporting to monitor disease trends
and plan prevention programs).
-Other circumstances:
* Authorized agencies that work with prospective adoptive or foster
parents may have access to this information.
* A judge can issue a special court order that requires release of HIV-
related information. HIV-related information cannot be released in response
to a subpoena issued by an attorney.

【在 A*******s 的大作中提到】

: True, but the HIV patient has to agree. Or the physician is liable.
: Public health office is a place the physician should defer to.
:
: have
: similar

S******9
发帖数: 2837

step1 里面说建议病人告诉伴侣，如果病人不说，医生有责任通知可能的被感染者；如
果有多个伴侣的，医生不能明确是是那些的，要报告给卫生保护机构，由他们通知这些
伴侣。这个属于可以break confidential的情况

A*******s
发帖数: 9638

Yes. I agree with what the Law said.
But this law provides no details on HOW.
This patient clearly does not want to disclose anything about HIV. If you do
it, you will breech confidentiality.

without
s
each
general

【在 L****n 的大作中提到】

: i don't think so. the law is VERY CLEAR on this aspect:
: ***Under what circumstances can HIV-related information be disclosed without
: an approved HIV release form?***
: -For medical treatment:
: * Medical professionals working on the treatment team with the person's
: existing provider may discuss a patient's HIV-related information with each
: other or with their supervisors, but only to give necessary care. A general
: release is needed to disclose medical information to a provider who is not
: affiliated with the person's current medical provider.
: * With a general release, a hospital or health care provider may share

L****n
发帖数: 12932

one person's privacy should NOT take precedent over public safety.

A*******s
发帖数: 9638

我会defer to health agent。
否则我会被sue的。

【在 S******9 的大作中提到】

: step1 里面说建议病人告诉伴侣，如果病人不说，医生有责任通知可能的被感染者；如
: 果有多个伴侣的，医生不能明确是是那些的，要报告给卫生保护机构，由他们通知这些
: 伴侣。这个属于可以break confidential的情况

A*******s
发帖数: 9638

我同意。
但是个人不要involve.

【在 L****n 的大作中提到】

: one person's privacy should NOT take precedent over public safety.

A*******s
发帖数: 9638

Read this：
Warning Third Parties
Any physician who diagnoses a contagious disease has a duty to counsel the patient about the communicability of the disease and to ensure that any other persons at risk are warned. This duty has been clear and explicit in the laws of this country since the nineteenth century. This duty can be discharged directly, by warning the exposed individuals, or indirectly, by reporting the disease to public health officials or by counseling the patient to warn persons at risk. The proper method of discharging this duty to warn is shaped by the applicable reporting and privacy laws. The patient's privacy is BEST protected by indirect warnings through the health department. This route may be ineffective, however, in jurisdictions where the health department declines to warn persons who are exposed to communicable diseases such as HIV. For example, a physician who treated a married man with syphilis would have to report the disease to the local health department, which would contact the man's wife. They would interview her to determine if there were other contacts who might require treatment. The physician would have discharged his or her duty to warn the wife and to report disease. The health department also protects the patient's confidence. A disease investigator does not tell a contact to a communicable disease carrier who the carrier is--simply that there has been a contact.
In this case, if the wife has not had sexual relations with anyone except
her husband, she will know who her contact was. It is important to keep in
mind that the resulting family problems are not the fault of the reporting
physician if the health department does the warning. Conversely, if a
physician attempts to warn a person at risk and does so negligently, the
physician may be liable for the ensuing marital disharmony.
http://biotech.law.lsu.edu/books/lbb/x575.htm

L****n
发帖数: 12932

out 了。 “Molien v. Kaiser Foundation Hospitals. 616 P2d 813 (1980)”
when there is clearly defined legal statue, one should do what the law says.
If still not comfortable, make a call to the risk management office and
have the lawyer answer the question.

【在 A*******s 的大作中提到】

: Read this：
: Warning Third Parties
: Any physician who diagnoses a contagious disease has a duty to counsel the patient about the communicability of the disease and to ensure that any other persons at risk are warned. This duty has been clear and explicit in the laws of this country since the nineteenth century. This duty can be discharged directly, by warning the exposed individuals, or indirectly, by reporting the disease to public health officials or by counseling the patient to warn persons at risk. The proper method of discharging this duty to warn is shaped by the applicable reporting and privacy laws. The patient's privacy is BEST protected by indirect warnings through the health department. This route may be ineffective, however, in jurisdictions where the health department declines to warn persons who are exposed to communicable diseases such as HIV. For example, a physician who treated a married man with syphilis would have to report the disease to the local health department, which would contact the man's wife. They would interview her to determine if there were other contacts who might require treatment. The physician would have discharged his or her duty to warn the wife and to report disease. The health department also protects the patient's confidence. A disease investigator does not tell a contact to a communicable disease carrier who the carrier is--simply that there has been a contact.
: In this case, if the wife has not had sexual relations with anyone except
: her husband, she will know who her contact was. It is important to keep in
: mind that the resulting family problems are not the fault of the reporting
: physician if the health department does the warning. Conversely, if a
: physician attempts to warn a person at risk and does so negligently, the
: physician may be liable for the ensuing marital disharmony.
: http://biotech.law.lsu.edu/books/lbb/x575.htm

A*******s
发帖数: 9638

In this case, I would not say more other than " I could not disclose due to
HIPPA" There is clearly a conflict and potential breech of confidentiality.
But I will defer to health department/risk management.

says.

【在 L****n 的大作中提到】

: out 了。 “Molien v. Kaiser Foundation Hospitals. 616 P2d 813 (1980)”
: when there is clearly defined legal statue, one should do what the law says.
: If still not comfortable, make a call to the risk management office and
: have the lawyer answer the question.

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C*****D
发帖数: 1299

I know if the HIV positive deliberately had unprotected sex could be sued
for sexual assault.
I think legally, you only can tell the patient, and report to the state. The
sex partner should ask that question by his/herself.
If you know he/she deliberately have unprotected sex, you have the
obligation to report, usually risk management or legal department of your
hospital.

c******s
发帖数: 5583

我遇到过很多次这种恶心的事，让我难受很久

A*******s
发帖数: 9638

一不小心多说一句就会印证这句名言：
No good deed goes unpunished。

【在 c******s 的大作中提到】

: 我遇到过很多次这种恶心的事，让我难受很久

k********n
发帖数: 756

By law and moral code, the husband has to be notified by the physician or
the third party.

V*****G
发帖数: 337

I agree, this was written in textbook.
this is a clear case that confidentiality must be breached.
I wonder why the ID doctor didn't tell the HIV patient that by law, his
partner must be informed, either by
patient him/herself, or doctor. Actually, I think if the id doc doesn't
breach the confidentiality, he will get
trouble. Not the other way around.

【在 S******9 的大作中提到】

f******w
发帖数: 10267

Here is what AMA says, I guess it's a basic guideline when dealing with
patient confidentiality. Different states have different laws in regard of
the diseases that are public danger, such as STDs, whether to report them to
authorities depends on what the state law says. But the utmost important
thing in USA is an individual's rights. Physicians can easily get into
legal trouble if they are not following the laws, especially for us CMGs who
are from a totally different ethical background.
http://www.ama-assn.org/ama/pub/physician-resources/legal-topic

c******s
发帖数: 5583

-you can't tell her anything.
-you can't hint her anything.
-you can try to convince him telling her directly (never worked for me).
-call ID and ask them to contact CDC or social services to offer voluntary
HIV test to her w/o you being involved.

V*****G
发帖数: 337

I also googled and confirmed that known partners of an HIV person must be
nofitied by physician or public health officer (this is in new york state)
without an approved HIV release form:
http://www.health.state.ny.us/diseases/aids/facts/helpful_resou
Under what circumstances can HIV-related information be disclosed without an
approved HIV release form?
Known partners of an HIV-positive person must be notified that they have
been exposed to HIV by a physician or public health officer.
Can we do this: print the page and show it to patient and tell him/her
that the partner will be informed regardless his/her consent or not, I am very sorry for this, but this
is by law, and then give him/her 3 options:
1. tell partner him/herself
2. I will tell
3. Health officer will tell

z******1
发帖数: 666

This is a standard casse in medical ethics course. It is interesting this
case can cause misunderstanding among chinese attending doctors. It seems
there is huge difference among china and US medical culture.This HIV
disclosure case was brought by a case about a mental patient told his doctor
he would kill his girl friend. The doctor failed to warn the women and she was
killed.
I remember there is a question in my step2 exam that a chinese son
refused the doctor to tell truth about his father's terminal cancer illness.
What the doctor should do?

A*******s
发帖数: 9638

Not that simple. You just can not follow a law and break the other. You
simply do not want to get into any troubles like that.
Like I said above, follow the law of HIPPA as a priority. Knowning your
responsibilities, hopefully you solve the issue with the patient to get his
consent. If he disagrees, you just do NOT confront him by breeching
confidentiality. You will get sued no matter what is going to happen. Do
you want the hassles? Of course not.
Defer to risk management/health agent and save your precious time and stay
away from the trouble.
The ID attending got fired eventually, not sure if it was relevant.
On a CS mock test, a resident argued about the same issue and also failed
the test, according to a website.

an
very sorry for this, but this

【在 V*****G 的大作中提到】

: I also googled and confirmed that known partners of an HIV person must be
: nofitied by physician or public health officer (this is in new york state)
: without an approved HIV release form:
: http://www.health.state.ny.us/diseases/aids/facts/helpful_resou
: Under what circumstances can HIV-related information be disclosed without an
: approved HIV release form?
: Known partners of an HIV-positive person must be notified that they have
: been exposed to HIV by a physician or public health officer.
: Can we do this: print the page and show it to patient and tell him/her
: that the partner will be informed regardless his/her consent or not, I am very sorry for this, but this

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V*****G
发帖数: 337

I agree with your approach, leave the issue to the risk management/health
agent at the hospital/medical center. This is the best probably for a
physician.
For Confidentiality vs The Duty to Warn, you can find more and read more
here, there are a few tips of how to avoid the dilemma:
This is a legislative advice for social worker in Louisiana about HIV
confidentiality vs Duty to warn (failing either one can get physician sued,
breaching confidentiality is sueable, Faiure of Duty to Warn is also
sueable, this is the dilemma for our physicians.)
In lousiana, this is a no clear cut issue, no clear guideline, still in
debate.
http://www.aidslaw.org/confidentiality.pdf

his

【在 A*******s 的大作中提到】

: Not that simple. You just can not follow a law and break the other. You
: simply do not want to get into any troubles like that.
: Like I said above, follow the law of HIPPA as a priority. Knowning your
: responsibilities, hopefully you solve the issue with the patient to get his
: consent. If he disagrees, you just do NOT confront him by breeching
: confidentiality. You will get sued no matter what is going to happen. Do
: you want the hassles? Of course not.
: Defer to risk management/health agent and save your precious time and stay
: away from the trouble.
: The ID attending got fired eventually, not sure if it was relevant.

A*******s
发帖数: 9638

HIPPA is for the patient. The other law is to protect the innocent(wife,
partners, etc). We need to take care of both with the ART.

sued,

【在 V*****G 的大作中提到】

: I agree with your approach, leave the issue to the risk management/health
: agent at the hospital/medical center. This is the best probably for a
: physician.
: For Confidentiality vs The Duty to Warn, you can find more and read more
: here, there are a few tips of how to avoid the dilemma:
: This is a legislative advice for social worker in Louisiana about HIV
: confidentiality vs Duty to warn (failing either one can get physician sued,
: breaching confidentiality is sueable, Faiure of Duty to Warn is also
: sueable, this is the dilemma for our physicians.)
: In lousiana, this is a no clear cut issue, no clear guideline, still in

j****1
发帖数: 15497

这个医生这样说是对的啊，最起码，以美国的法律和人情来说。
不是傻子的人应该都能听出来吧
这是step 1 要问的问题

【在 A*******s 的大作中提到】

A*******s
发帖数: 9638

There is a gulf between what is right and what is legal. Believe or not.

【在 j****1 的大作中提到】

: 这个医生这样说是对的啊，最起码，以美国的法律和人情来说。
: 不是傻子的人应该都能听出来吧
: 这是step 1 要问的问题

R******f
发帖数: 32

Believe it or not.
Can someone give us a summary? There were so many voices. It is hard to
tease out facts from personal opinions. I am totally lost here.

【在 A*******s 的大作中提到】

: There is a gulf between what is right and what is legal. Believe or not.

d**o
发帖数: 618

搭车讨论一下，美国对于HBV的public health policy又是怎样的呢？我已经遇到两个
乙肝大三阳，HBV DNA count几万的病人了，都是在当地有名的中餐馆打工，一个是大
厨，一个是服务员，都没医疗保险。医生完全没有要通知餐馆或卫生局的想法，呵呵。
当然，美国人普遍打HBV疫苗，的确关系不大。

f******w
发帖数: 10267

Here we go, under "contact management" section.
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5708a1.htm

【在 d**o 的大作中提到】

: 搭车讨论一下，美国对于HBV的public health policy又是怎样的呢？我已经遇到两个
: 乙肝大三阳，HBV DNA count几万的病人了，都是在当地有名的中餐馆打工，一个是大
: 厨，一个是服务员，都没医疗保险。医生完全没有要通知餐馆或卫生局的想法，呵呵。
: 当然，美国人普遍打HBV疫苗，的确关系不大。

d**o
发帖数: 618

Get it, thanks! Can't remember where I got the wrong impression that HBV
should not prepare food. Must be wrong teaching in China.

【在 f******w 的大作中提到】

: Here we go, under "contact management" section.
: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5708a1.htm

A*******s
发帖数: 9638

I brought this up because of the controversy.
Apparently the attending did a right thing(to his wife) but legally wrong(to
the patient). The attending's first sentance was right. But the 2nd one
suggested her LD has HIV. This is violation of HIPPA.
How to warn the party? Read this please(it was in my post):
http://biotech.law.lsu.edu/books/lbb/x575.htm
The summary is what I've said above. Do it legally, not just do it right. Or
you will taste the bitterness: No good deed goes unpunished.
Sound familiar? lol.

【在 R******f 的大作中提到】

: Believe it or not.
: Can someone give us a summary? There were so many voices. It is hard to
: tease out facts from personal opinions. I am totally lost here.

f******w
发帖数: 10267

不瞒您说，我肯定不敢去那个大厨的餐厅吃饭。

【在 d**o 的大作中提到】

: Get it, thanks! Can't remember where I got the wrong impression that HBV
: should not prepare food. Must be wrong teaching in China.

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A*******s
发帖数: 9638

Then you'd better stay away from all Chinese restaurants.

【在 f******w 的大作中提到】

: 不瞒您说，我肯定不敢去那个大厨的餐厅吃饭。

h******e
发帖数: 1811

嗯，咱正在努力把自己培养成大厨。

【在 A*******s 的大作中提到】

: Then you'd better stay away from all Chinese restaurants.

c****n
发帖数: 21367

this doc may get big trouble
when the patient sue for violation of privacy.
the wife's question should be handled by
a police officer or a public health officer
regardless of the result of HIV test.

【在 A*******s 的大作中提到】

A*******s
发帖数: 9638

haha, you are westernized, my friend.

【在 c****n 的大作中提到】

: this doc may get big trouble
: when the patient sue for violation of privacy.
: the wife's question should be handled by
: a police officer or a public health officer
: regardless of the result of HIV test.

f******w
发帖数: 10267

恕我愚钝，police officer在这里面是啥意思？

【在 c****n 的大作中提到】

A*******s
发帖数: 9638

A federal grand jury on Tuesday indicted a Suffolk doctor for allegedly
disclosing a patient’s health information to the patient’s employer.
Richard Alan Kaye, 62, of Suffolk was indicted by a federal grand jury for
the wrongful disclosure of individually identifiable health information
under the Health Insurance Portability and Accountability Act.
If convicted, Kaye faces a maximum penalty of five years imprisonment
http://www.suffolknewsherald.com/2011/06/21/suffolk-doctor-indi

A*******s
发帖数: 9638

大约2个月前我的一个病人跟我抱怨一位印度pulmonary attending把他的alcoholism泄
露给他的employer。他的雇主打电话问这个印度医生为什么他不能上班，不知道这个
印度医生是不是忙昏了头还是什么，居然说了alcoholism上不了班。
1个月前这个病人死了。

f******w
发帖数: 10267

这种case能打赢。。。。真的很难很难！估计这个employer也是个mama papa shop。

【在 A*******s 的大作中提到】

: A federal grand jury on Tuesday indicted a Suffolk doctor for allegedly
: disclosing a patient’s health information to the patient’s employer.
: Richard Alan Kaye, 62, of Suffolk was indicted by a federal grand jury for
: the wrongful disclosure of individually identifiable health information
: under the Health Insurance Portability and Accountability Act.
: If convicted, Kaye faces a maximum penalty of five years imprisonment
: http://www.suffolknewsherald.com/2011/06/21/suffolk-doctor-indi

A*******s
发帖数: 9638

N*G
发帖数: 217

I think what that Doc said is appropriate.

相关主题
● Is new working hour restriction good or bad?
● 谈不上新闻，一些和CMG有关的事情
● 看病网
● 医生们之间互相打听病人病史吗？
进入Medicalpractice版参与讨论

f******w
发帖数: 10267

: I think what that Doc said is appropriate.

L****n
发帖数: 12932

是要保护当事人的privacy, 但起码要告诉性伴侣wear protection, not just check
for HIV.

情。

【在 f******w 的大作中提到】

f******w
发帖数: 10267

可以旁敲侧击地提醒，比如，Using protection will give you peace of mind。但是
作为医生本人，手脚本来就是被法律困住的。

【在 L****n 的大作中提到】

: 是要保护当事人的privacy, 但起码要告诉性伴侣wear protection, not just check
: for HIV.
:
: 情。

L****n
发帖数: 12932

: 可以旁敲侧击地提醒，比如，Using protection will give you peace of mind。但是
: 作为医生本人，手脚本来就是被法律困住的。

N*******r
发帖数: 118

A*******s
发帖数: 9638

严格的说，这个attending还是有breech of confidentiality. 道德上他可能是对的
，但法律上，他是liable for breech of confidentiality.

A*******s
发帖数: 9638

“但我建议你做HIV检查”间接肯定了LD的疑问，医生是liable的。

答的

【在 N*******r 的大作中提到】

L****n
发帖数: 12932

A*******s
发帖数: 9638

True, but the HIV patient has to agree. Or the physician is liable.
Public health office is a place the physician should defer to.

have
similar

【在 L****n 的大作中提到】

L****n
发帖数: 12932

: True, but the HIV patient has to agree. Or the physician is liable.
: Public health office is a place the physician should defer to.
:
: have
: similar

相关主题
● 医生们之间互相打听病人病史吗？
● Rotation in transplant surgery
● 医疗实践中的安全问题
● Good Article to share
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S******9
发帖数: 2837

A*******s
发帖数: 9638

L****n
发帖数: 12932

one person's privacy should NOT take precedent over public safety.

A*******s
发帖数: 9638

我会defer to health agent。
否则我会被sue的。

【在 S******9 的大作中提到】

A*******s
发帖数: 9638

我同意。
但是个人不要involve.

【在 L****n 的大作中提到】

: one person's privacy should NOT take precedent over public safety.

A*******s
发帖数: 9638

L****n
发帖数: 12932

A*******s
发帖数: 9638

C*****D
发帖数: 1299

c******s
发帖数: 5583

我遇到过很多次这种恶心的事，让我难受很久

相关主题
● 我真傻，真的....
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● Have you read this?
● CMG Physician Database - 新网页
进入Medicalpractice版参与讨论

A*******s
发帖数: 9638

一不小心多说一句就会印证这句名言：
No good deed goes unpunished。

【在 c******s 的大作中提到】

: 我遇到过很多次这种恶心的事，让我难受很久

k********n
发帖数: 756

By law and moral code, the husband has to be notified by the physician or
the third party.

V*****G
发帖数: 337

f******w
发帖数: 10267

c******s
发帖数: 5583

V*****G
发帖数: 337

z******1
发帖数: 666

A*******s
发帖数: 9638

V*****G
发帖数: 337

A*******s
发帖数: 9638

HIPPA is for the patient. The other law is to protect the innocent(wife,
partners, etc). We need to take care of both with the ART.

sued,

【在 V*****G 的大作中提到】

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进入Medicalpractice版参与讨论

j****1
发帖数: 15497

这个医生这样说是对的啊，最起码，以美国的法律和人情来说。
不是傻子的人应该都能听出来吧
这是step 1 要问的问题

【在 A*******s 的大作中提到】

A*******s
发帖数: 9638

There is a gulf between what is right and what is legal. Believe or not.

【在 j****1 的大作中提到】

: 这个医生这样说是对的啊，最起码，以美国的法律和人情来说。
: 不是傻子的人应该都能听出来吧
: 这是step 1 要问的问题

R******f
发帖数: 32

Believe it or not.
Can someone give us a summary? There were so many voices. It is hard to
tease out facts from personal opinions. I am totally lost here.

【在 A*******s 的大作中提到】

: There is a gulf between what is right and what is legal. Believe or not.

d**o
发帖数: 618

f******w
发帖数: 10267

Here we go, under "contact management" section.
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5708a1.htm

【在 d**o 的大作中提到】

d**o
发帖数: 618

Get it, thanks! Can't remember where I got the wrong impression that HBV
should not prepare food. Must be wrong teaching in China.

【在 f******w 的大作中提到】

: Here we go, under "contact management" section.
: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5708a1.htm

A*******s
发帖数: 9638

: Believe it or not.
: Can someone give us a summary? There were so many voices. It is hard to
: tease out facts from personal opinions. I am totally lost here.

f******w
发帖数: 10267

不瞒您说，我肯定不敢去那个大厨的餐厅吃饭。

【在 d**o 的大作中提到】

: Get it, thanks! Can't remember where I got the wrong impression that HBV
: should not prepare food. Must be wrong teaching in China.

A*******s
发帖数: 9638

Then you'd better stay away from all Chinese restaurants.

【在 f******w 的大作中提到】

: 不瞒您说，我肯定不敢去那个大厨的餐厅吃饭。

h******e
发帖数: 1811

嗯，咱正在努力把自己培养成大厨。

【在 A*******s 的大作中提到】

: Then you'd better stay away from all Chinese restaurants.

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● 这个case不分享真对不起大家。
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c****n
发帖数: 21367

A*******s
发帖数: 9638

haha, you are westernized, my friend.

【在 c****n 的大作中提到】

f******w
发帖数: 10267

恕我愚钝，police officer在这里面是啥意思？

【在 c****n 的大作中提到】

A*******s
发帖数: 9638

f******w
发帖数: 10267

这种case能打赢。。。。真的很难很难！估计这个employer也是个mama papa shop。

【在 A*******s 的大作中提到】

D**i
发帖数: 325

óD2?

【在 A*******s 的大作中提到】

(共1页)

进入Medicalpractice版参与讨论

相关主题
● Have you read this?
● CMG Physician Database - 新网页
● A very good article "Suicide and the Young Physician"
● (bssd) 如果你的亲人得了重病，你会让他知道吗
● 关于寻医问药的几点说明。
● 夫妻共用一个EMAIL的悲剧
● 这个case不分享真对不起大家。
● 明年medicare reimbursement 削减27.4%
● 现实和理想的差距--一个新医生的困惑
● 请教一下这里的医生们一个问题

相关话题的讨论汇总
话题: hiv话题: health话题: patient话题: physician

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