Many technological innovations of the last decades accelerate the transformation of the medical practice, leading to the discovery of disease-targeted genes (biomarkers) that enabled ever growing availability of improved diagnostic, treatments, and, cure (Falk et al. 2003), besides the potential prevention of inherited diseases (Smets et al. 2007). The post-genomic era deals with issues that are morally loaded in our culture, such as reproductive choices, family and individual decisions with far reaching implications for patients and relatives (Smets et al. 2007).
Nowadays, Genetic Test (GT) is the standard medical tool that allows the identification of mutation-carrying relatives. Sakurai and colleagues (2006) have described…show more content… Such principle prevents physicians from disclosing facts due to the professional exercise, except for a just cause, statutory duty or given patients’ consent. This rule assures that the patient’s information is preserved, providing patients a safe environment to share their innermost secrets, and physicians with more evidence to fully understand their patient’s problems and treat them accordingly.
Information confidentiality is a key factor in genetic counselling, as patients do not always communicate genetic medical information to at-risk relatives themselves (Clarke et al. 2005). These family members may then be denied the opportunity to take informed health decisions, for example, in relation to reproduction or the (preventive) management of a disease’s risks (Godard et al. 2006). Nevertheless, medical information confidentiality is not an absolute concept, but must be nurtured and protected whenever possible, as its disclosure is always based on ethical, legal and social reasons, and must always occur with caution – only under very special and situated circumstances of healthcare…show more content… 2006), whereby the principle of confidentiality is not absolute and healthcare professionals may lawfully disclose otherwise confidential information (ASHG, 1998), for example, under legal, ethical and/or statutory obligations, or for public benefit (Godard et al. 2006, Erde et al. 2006). Under the ‘public benefit’ exception lie the roots for the ‘duty to warn’ third parties in the context of the physician–patient relationship (Godard et al. 2006). Failure to warn may lead to irreparable harm if opportunities for avoidance, treatment, or prevention of conditions are limited (ASHG, 1998); therefore, the harm that may result from failure to disclose should outweigh the harm that may result from disclosure.
In this case, the duty of conﬁdentiality is relative and, although breach of conﬁdential information can have deleterious consequences, particularly for the physician–patient relationship, failure to disclose it can cause serious implications for the well-being of the patient, his/her family and the society (Agyapong et al. 2009). Therefore, when relevant medical information secrecy causes serious third-party damage, courts have leaned toward the ‘right to know’, condemning the ‘right to conﬁdentiality’ (Godard et al.