Kipnis's Poem Analysis

The concept of unqualified confidentiality means that confidentiality must not be broken under any exceptions. Contrary to Kipnis’s views, I argue that confidentiality should be qualified because doctors have more obligations than just confidentiality, a third party’s health and safety should not be used as mere means, and doctors must consider
Kipnis’s first argument is that our legal obligations are not the same as our moral or professional duties (50). Because one’s ethics and the law can come into conflict in certain situations, they must be considered separate.
Kipnis makes a valid point here. Because laws are shared rules to be implemented over a large population, it often fails to consider the uniqueness of situations.
Another of
If the doctor’s maxim was also to better public health, he would run into a logical inconsistency. He would be damaging the health of the third party and harming a possible therapeutic relationship. The doctor’s inaction caused harm to someone else who will now become his patient.
Also, W. D. Ross’s Ethical Pluralism would argue otherwise. Fidelity, or duties of keeping promises, is only one of the prima facie duties (Waluchow and Gedge, xxx). By implementing the unqualified confidentiality rule, other prima facie duties such as non-maleficence or non-injury to others and beneficence would be violated in his scenario. Another argument of Kipnis is that the current laws that were implemented under consequentialist theories do not actually minimize the negative outcomes (56). Kipnis related a scenario where people who feared the breach in confidentiality will avoid seeking treatment which will then put themselves and others at risk (56). In this argument, Kipnis reasoned that the unqualified confidentiality rule would maximize utility because patients who would initially avoid doctors would now seek treatment (56). Should there be a risk to a third party, Kipnis said that the doctor should then persuade the patient to waive their confidentiality (56). However, patients who refuse to waive this right cannot be forced into doing so because Kant’s theory respects people’s autonomy (Waluchow and Gedge,
Because people are autonomous, they control their own decisions (Waluchow and Gedge, xxviii). If the patient refuses to waive confidentiality or inform the third party of the potential harm, then it is not the fault of the doctor. In Kant’s perspective, the doctor can only control his own actions and moral decisions.
In this instance, the doctor has only considered his obligation to the patient and not the third party. The doctor has inadvertently placed more value on the patient’s health, going against Kant’s theory that everyone is inherently valuable (Waluchow and Gedge, xxviii). In qualified confidentiality, doctors must then ensure that patients understand that breaching their confidentiality only occurs when they will harm others with their choices.
In conclusion, confidentiality should be qualified. Doctors have the obligation of non-maleficence and beneficence to the community; therefore, they must consider the potential harm their inaction might cause the vulnerable. The risk to my safety should also not be a means to get a patient to be more likely to consider treatment. Lastly, doctors should consider the best interests of everyone, not just his current