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To the Editor: Dr Offit and colleagues¹ conclude that, in general, physicians have a duty to advise patients with genetic disorders of an obligation to inform their relatives, but that physicians do not have a duty to breach patient confidentiality to warn patients’ relatives directly. This is consonant with the beliefs of the public.² The authors argue cogently that the precedent of the Tarasoff case³ may not apply from a legal perspective because confidentiality still has an important role in medical practice (now strengthened by Health Insurance Portability and Accountability Act regulations), and genetic disorders may not have a high penetrance and may not be treatable.

From an ethical perspective, this case diverges from the Tarasoff precedent in 2 other important ways.⁴ First, the lack of imminence of the harm from genetic disorders offers many other opportunities for affected relatives to learn of their diagnosis, so that all means of . . . [Full Text of this Article]

Daniel P. Sulmasy, OFM, MD, PhD
daniel_sulmasy@nymc.edu
St Vincent’s Hospital-Manhattan and New York Medical College
New York, NY

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The "Duty to Warn" a Patient's Family Members About Hereditary Disease Risks
Kenneth Offit, Elizabeth Groeger, Sam Turner, Eve A. Wadsworth, and Mary A. Weiser
JAMA. 2004;292(12):1469-1473.
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