The Physician Who Knew Too Much: A Comment on Watters v White

Abstract

With the sequencing of the human genome in 2003, the role of medical genetics in health care continues to expand. While allowing for new opportunities, especially in personalised medicine, this developing field also creates uncertainty about the duties physicians owe their patients. An area of particular controversy is the scope of the physician's duty to inform relatives of a patient of potentially important genetic information. The 2010 Quebec Superior Court decision Liss v Watters dealt with such an issue. The central allegation in this case was that two physicians failed to inform the mother and relatives of a patient affected by a genetic condition of their carrier status. In this case, the Quebec Court of Appeal ultimately concluded that the duty to inform could not be expanded without undermining the physician's duty to uphold professional secrecy. While the alleged faults in this case took place decades ago, Watters v White poses key questions about physician duties to communicate genetic information. First and foremost, does a physician have a duty to inform patients' relatives of serious genetic risks? If so, what is the scope of this duty? What sorts of genetic risks must be communicated? Which relatives should be informed? Does physician-patient confidentiality bar such communications? If so, must physicians seek alternative means to ensure that at-risk individuals are informed? Important issues of causation also arise in Watters v White. This case commentary begins by outlining the facts of this case. Next, the reasoning and conclusions of both the trial and Court of Appeal judgments are discussed. The commentary concludes with a discussion of the implications of this case for physicians in today's rapidly evolving genetic milieu.