The principle of 'therapeutic privilege' in informed consent allows a doctor to withhold specific risk information from a patient in which limited circumstance?

• A When disclosure would cause the patient to refuse a treatment the doctor believes is necessary
• B When disclosure would significantly compromise patient wellbeing or lead to serious psychological harm ✓
• C When the patient is below the age of 18 years
• D When the procedure is covered under a standard hospital protocol

Explanation

Therapeutic privilege is a narrow and contested exception to full informed consent. It permits withholding specific risk information only when its disclosure would cause significant harm to the patient's health (e.g., severe psychological decompensation, suicidal risk from disclosure of a fatal diagnosis in an unstable patient). Option A is the historic and now-rejected 'paternalistic' misuse of the privilege — a doctor cannot withhold consent simply because the patient might refuse. The privilege is to protect the patient, not the doctor's treatment plan. Its use must be documented and is subject to ethical and legal scrutiny.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

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Written and medically reviewed by the StethoPrep medical team.