What are the ethical considerations around disclosing a patient’s prognosis to family members without patient consent?

• A. Share prognosis with family without patient consent.
• B. Disclose only to the nurse team.
• C. Withhold prognosis from everyone.
• D. Respect patient autonomy and confidentiality; share prognosis only with patient or with consent, unless patient lacks capacity and legal requirements authorize disclosure.

Answer: (D)

Respect for patient autonomy and confidentiality governs how prognosis information is shared. The patient should have control over who receives personal health information, including prognosis. Sharing prognosis with family without the patient’s consent breaches the patient’s right to decide who hears their information and can erode the trust essential to the care relationship. The ethical approach is to discuss the prognosis with the patient first and obtain consent before sharing with family. If the patient lacks capacity, the clinician should disclose to a legally authorized representative or according to an advance directive or applicable law, rather than sharing unilaterally. This respects autonomy while ensuring information is used to support care where appropriate. Other options fail because they either violate confidentiality, restrict information to the care team without patient involvement, or withhold information in a way that contradicts the patient’s rights and preferences.