Between Clinic and Community: A Narrative Review of Ethical and Operational Frameworks for Mandatory Disease Reporting
Abstract
Background: Mandatory disease reporting is a cornerstone of public health security, enabling surveillance, outbreak control, and resource allocation. However, this critical function exists at a complex nexus of clinical care, diagnostics, legal mandate, and epidemiological science, creating inherent tensions between individual patient rights and collective public good.
Aim: This narrative review synthesizes contemporary literature (2010-2024) to analyze the ethical dilemmas and operational challenges inherent in mandatory reporting systems, focusing on the interdependent roles and responsibilities of frontline clinical staff, diagnostic services, legal authorities, and epidemiological agencies.
Methods: A comprehensive search was conducted across PubMed, Scopus, LawNet, PsycINFO, and CINAHL databases. Search terms combined "mandatory reporting," "notifiable diseases," "public health ethics," "duty to warn," with stakeholder roles ("nurse," "laboratory," "pharmacy," "epidemiology inspector").
Results: The review identifies persistent tensions: patient confidentiality versus the duty to protect the community; clinical discretion versus strict legal compliance; and the burden of reporting on frontline staff. Operationally, success hinges on seamless collaboration: clinical providers (nurses, health assistants) initiate reports based on suspicion; diagnostic services (labs) provide confirmatory data and are often legally obligated reporters; treatment providers (pharmacy) can signal unusual prescription patterns; legal authorities (Ministry of Health) define reportable conditions and penalties; and epidemiological inspectors verify, investigate, and act on data.
Conclusion: Effective mandatory reporting requires integrated frameworks that balance ethical imperatives through transparent justification and proportionality, and streamline operations via standardized digital tools, interdisciplinary training, and closed-loop feedback.
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Authors
Copyright (c) 2024 Fatimah Saleh Alkhozam, Majedah Saeed Al-Yousef, Noof Mohammed Almohsen, Sultan Ali Safhi, Abdulrahman Abdullah, Abdulhadi Mohamd Abdulhadi Almannaa, Mariam Ahmad Aldoukhi, Abdalrhman Mohammad Alshiky, Naif Ali Hadi Harbi, Meshari Fahad Alsahli, Adel Eid Almutairi
This work is licensed under a Creative Commons Attribution 4.0 International License.