Ask the Ethicist

So I haven't posted for a month. A MONTH. I hereby apologize to all of you out there depending on blog updates to procrastinate from your usual life, but in all honesty, internet access here in Ghana has been total craperoni for the past few weeks. The only way I'm on right now is because my advisor lent me her mobile modem for a few minutes, so this has to be quick. Stay posted for more updates (hopefully) soon!

So as some of you know, I'm conducting a chart review of all the pediatric patients that Korle-Bu Retro Clinic has started on Antiretrovirals since they became available in Ghana. This means that I spend long loving hours in the medical records room sweating, getting dusty, wading through occasionally flooded corridors, and loving my job. ;) But seriously it has really helped me learn more about the clinical management of pediatric HIV. Repetition! Repetition! Woo!

So yesterday I came across a patient's chart with a sealed envelope inside. It contained the VCT (Voluntary Counselling and Testing) results of the patient's father. Now, I am collecting parental data, and want to know if the patient's parents are HIV+ or not. My ethical question for today, dear readers, is:

Would it be ethical to open that sealed envelope in order to get my data?

On one hand, the data is in the patient's chart, which is all confidential. I have been granted access to this confidential data, and am protecting it appropriately, so I am entitled to view everything in the folder.

On the other hand, if the patient's father himself has not yet opened this envelope, then perhaps this is his passive way of saying he does not want to know his status. In a way, the patient is voiding the fact that the test was ever done, and I'm not entitled to expose him (myself, or anyone else) to his data.

In the end, I couldn't take the risk of violating the father's privacy. I left the envelope sealed, left my data entry point blank, and decided that only a patient can be the one to unseal their own medical records. The envelope's presence in the chart was not reason enough for me to view its contents. Weigh in! Let me know what you think!