In the Carlos R case, an adult with HIV does not want to disclose to his sister. This raises tensions between which principles?

• A. Paternalism and Autonomy
• B. Autonomy and Justice
• C. Veracity and Privacy
• D. Confidentiality and Beneficence

Answer: (D)

The main tension is between protecting a patient’s confidentiality and acting for the welfare of others. Keeping the HIV status private respects the patient’s autonomy and trust, central to confidentiality. But beneficence involves doing good and preventing harm, which can argue for disclosure to a sister if her safety could be at risk or if she needs to take protective steps. So the scenario pits the duty to keep sensitive information private against the duty to prevent harm to someone else. The other pairings don’t capture this specific clash as directly: paternalism vs autonomy focuses on overriding patient choices, and veracity vs privacy centers on truth-telling versus privacy, whereas the core ethical conflict here is confidentiality versus beneficence.