Guideline 4: Patient privacy & confidentiality

Continue the conversation without discussing the sexual side effects. You don’t want to make Caterina (or George) uncomfortable.

By continuing on the conversation but omitting the sexual information, it could be detrimental to George who may want to discuss his sexuality.

Continue the conversation including a discussion of the impact of treatment on George’s erectile function with Caterina present.

Many patients are unlikely to discuss their sexuality in the presence of their adult children, particularly if they are widowed and may have a new partner. George is unlikely to share (or ask for) information if Caterina is present.

Politely ask Caterina to leave the consultation room for a few minutes as George needs to be physically examined. Acknowledge that this is a standard part of the consultation.

Some clinicians may find this approach most comfortable, however in some situations it may make the family member suspicious that they are being excluded (particularly if this occurs during the middle of a conversation). Using the private patient-clinician time before or after a physical examination strategically to discuss any sensitive issues can be useful.

Acknowledge that sensitive topics such as erectile, bowel, and bladder function need to be discussed and ask that Caterina leave the consultation room for a few minutes. Acknowledge that this is a standard part of the consultation.

Being open that sensitive issues need to be discussed, that these conversations can be difficult to have in front of others, and that asking family to leave for a few minutes is a standard part of the consultation can allow for the patient to have an open conversation while not making the family suspicious that secret conversations are occurring