Consider this scenario: A woman goes to her doctor to receive the results of a genetic test. The results show she does have the condition for which she was tested and this allows her doctor to prescribe a treatment strategy that will reduce her symptoms and delay (and perhaps prevent) the progression of the condition. Her doctor knows from their discussions that the woman has an identical twin sister and he asks if she is going to tell her sister of the test results. The sister could then undergo genetic testing herself and perhaps enter treatment. The woman says she does not want her family to know about her condition; as well she will not talk to her sister as they are not on speaking terms. The doctor knows the woman’s twin should be notified so that she can be helped also, but he has a duty of care to his patient. Which principles should be considered when trying to decide how to proceed?

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