A doctor has a duty to the public alongside their duty to their patient. The term ‘wider society’ can refer to the local community or the public at a national level depending on the impact that any given action taken by a doctor will have.
A situation in which this would be considered a reasonable suggestion would be on the issue of breaching confidentially to prevent others from being harmed. An example, is a patient with epilepsy who is experiencing frequent seizures but is still refusing to inform the DVLA if this and is continuing to drive. This could jeopardise the safety of others on the road so the doctor will be required to break confidentiality for the best interests of the many people who will be using the roads. Considering breaking confidentially would also be significant with regards to public health. If a doctor diagnoses a patient with Ebola, for example, the doctor has a legal obligation to inform public health. This is to ensure the safety of the wider public and allow necessary measures and procedures to be put in place to help prevent the spread of the disease.

Alternatively, the first line of the Hippocratic Oath reminds doctors that they have pledged to act in the best interests of their individual patients. A doctor’s ultimate responsibility lies directly with their patient so it may not be seen as the most ideal situation if the doctor is to break confidentiality for other people. Doctors must be seen as acting for the interests of the patient in front of them or their patients will begin to lose faith or confidence in them. A particular patient may require an expensive treatment which will use up a significant proportion of the budget. A doctor should not base their decision entirely on the basis of trying to distribute money available equally across every person in society. Some people will inevitably require more resources, such as the elderly or those with life long health complications. The doctor should therefore assess this by focussing of the clinical need of his patient alone.

With regards to medical treatment, there can be a large variation between the need of an individual and the needs of the public. It seems appropriate to consider the wellbeing of society as a whole in many cases such as with the discovery of a carrier of a rare and deadly disease. However, if doctors were to focus completely on the societal effects of their decisions, individual patients would be deprived of the specialist care they may need. Overall, a doctor should be able to set the balance as to when the patient should override wider society, and vice versa.

Posted by:Life of a Medic

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