6
‘‘Coming Out’’ as Patients
Disclosures of Illness
‘‘I felt we were living double lives,’’ Mathilde said, ‘‘as if we were pris-
oners twice’’—because of both illness and secrecy. Through decisions on
whether, what, when, and to whom to divulge their diagnosis, sick doc-
tors could alter or maintain others’ views of them. Some ill physicians
chose to lead double lives and live with secrets. Others went public. They
illustrated the degree to which information about one shapes how one is
viewed.
Clearly, doctors have a right to privacy concerning their personal health
information. Yet patients, and potentially certain colleagues, may have a
right to some of this information if it pertains to risks and benefits of
treatments that patients undergo. Thus, if a physician’s illness can po-
tentially harm a patient significantly, physician privacy can conflict with
patients’ rights. For example, for HIV, some have argued that a physician’s
disclosure of his or her illness may be relevant in exposure-prone proce-
dures (1). But what about in other situations? Do continuity of care and
trust ever warrant disclosure of a doctor’s illness? Do these decisions affect
doctor-patient relationships, and if so, how? These doctors viewed and
approached these issues in varying ways. They spent most of their wak-
ing lives with colleagues from whom they at times hid secrets. Importantly,
information bestowed power—either for or against the individual. Given
threats to medical privacy more broadly, due to the burgeoning electronic
storage and transfer of information, many aspects of these issues are tak-
ing on increasing urgency, but have been underexamined. Doctors’ dis-
closures of personal, nonmedical information have been probed, focusing
on casual remarks regarding their own attitudes and feelings toward
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