Regarding patient confidentiality, the limits, and what is morally acceptable must be clearly defined. The personal account model takes the perspective that the information given by patients to doctors is personal and should be treated as confidential. It is widely accepted that patients should have the ability to make their own decisions regarding their own medical care, to a point where they can choose to whether or not to accept life saving treatment.
In medicine, respect for confidentiality is very firmly established, with the most significant moral reason being the respect for the patient’s choice. The patient should have the right to decide what happens to the information they are giving to their clinician. The consequences of failing to respect patient confidentiality could result in the trust in the patient-doctor relationship being undermined. Patients who lose confidence in their doctor might not get the support that they need. If breaches of confidentiality were to become frequent, then there may be a lack of trust in health professionals at a societal level. Patients would think twice before going for checkups and other concerns.
With the joint account model, it is assumed that information should be available to all unless there are good reasons to do otherwise. A practical implication of the joint account model would be the storage of relevant genetic information to other family members. This would allow healthcare professionals to access them, create a family history, and then test for high-risk conditions. It would be up to the individual who didn’t want a specific family member to access the information to give an adequate reason as to why. The only times where it would justifiable with the joint account model would be where the individual can prove that there would be foreseeable harm from divulging the information.
A justification for the joint account model would be a moral duty. It should be a person’s moral duty to share genetic information because of the benefits to be gained and the harm to be avoided. By sharing genetic information, family members can benefit from coming forward and having testing because they know their family history. Legally, the genetic information is personal and therefore protected with confidentiality. The personal account model requires that the burden of proof rest with those who wish to breach confidentiality.
However, ethically in cases where there are no foreseeable harms to disclosing the information, there is a moral obligation to share the genetic information. Only genetic information which have no significant impact and are non-threatening should be personally owned; all other genetic information should be jointly owned. The genetic information that should be jointly owned would be shared with the impacted family members. Ethically one would also need to get the collective informed consent from everyone because it pertains to genetic information.