The following case presents a typical ethical dilemma in a rural community where public and personal lives are closely interwoven and health care clinics, doctors, and hospitals are few and far between.
Mrs. Sheila Murphy lives in a small town in the Foothill of Rocky mountain West. Her roots in this town are deep. Shiela's grandparents were ranchers and her aunts, uncles an cousins still live in the area. Ever since she had her husband announced her pregnancy there has ben much enthusiasm and support. Shiela considers herself lucky because she had her family known and trust Dr. Hughes a family physician who serves the small community. there is however a problem. During Shiela's last visit, Dr. Hughes discovered an open lesion and diagnosed it as a genital herpes lesion. Dr. Hughes explained that if Shiela has open lesion at the time of delivery, a C-section will have to be performed to prevent the child from becoming infected. Shiela is very upset. She says her husband knows about the problem and they do not want the information enter into her medical record. Sheila doesn't want Dr. Hughs to talk to anybody about her problem. She scheduled an appointment blieving she could rely on the "confidentiality" that has come always surrounded their relationship. Dr. Hughes understands Shiela's concern; the receptionist in Dr. Hughes office is Shiela's sister in law. Since the receptionist also types the patient's medical records, she will see any information if Dr Hughes plces in Shiela's chart. Sheila knows many of the nurse and aides who work in the hospital several of them are also members of the Church.