Ethical challenges in treating family members: A case study on confidentiality and clinical decision-making in the Indian context.

This case report explores the ethical complexities faced by physicians when providing medical advice and care to close family members. It focuses on a 29-year-old Indian woman residing in Western Europe who, while visiting family in Kerala, India, was diagnosed with IgA nephropathy during a routine health check. Several family members involved in her care are also practicing physicians, raising significant ethical questions about confidentiality, professional objectivity, and the boundaries of familial care. The case highlights the tension between patient autonomy and informal medical involvement by relatives, especially in a country such as India, where cultural expectations encourage familial responsibility. Although clinical care was efficiently delivered, the situation raised concerns about the formal decision-making process, the lack of clinical documentation, and the absence of established ethical frameworks within the Indian healthcare context. This report emphasizes the need for clearer guidelines and practical tools to help physicians navigate dual-role relationships while upholding confidentiality and clinical integrity. The patient's perspective and the follow-up are discussed, with implications for both policy and practice.