medical confidentiality

Standard

 Doctors should always maintain patient confidentiality and act with probity. Explain what is meant by the above statement. Why might probity be important in a good doctor? Under what circumstances might an honest doctor be justified in revealing patient details in the course of their professional practice?

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Patient confidentiality is the medical ethic which requires physicians to refrain from revealing information about patients to third parties. A doctor has access to a patient’s files and he or she has consultations with a patient. A patient will reveal a lot of highly sensitive personal information. Patients often find it excruciatingly embarrassing to talk about certain issues such as their sex lives or secret drug abuse. A patient must trust a doctor not to disclose the content of these consultations. Moreover, a patient will receive diagnoses and be on a course of treatment. A patient usually does not want everyone to know about this. This information is the patient’s information and he or she may choose to reveal this information or to keep it secret. It is not the doctor’s information and it is not his or her right to reveal this. 

Probity is honesty in the widest possible sense. A doctor should refrain from lying to a patient unless absolutely necessary. A doctor should not say things that are literally true but in fact misleading. Doctors have the public trust and it is vital that they do not abuse this trust or undermine trust in the medical profession by a lack of probity. Probity extends to doctors not cheating in their examinations. They must also behave in consonance with the highest Hippocratic principles. That is to say to act disinterestedly in always striving to achieve the best outcome for a patient. A doctor is also required to abide by a patient’s wishes if the patient is an adult of sound mind and it is a non-emergency situation. 

Doctors must have regard to the reputation of the medical profession. Probity requires them to avoid bringing the profession into disrepute by dishonest, criminal or other unethical behaviour that is unrelated to their profession. For example, a doctor who racially abuses people away from his practice would be in breach of probity. A doctor who lies to avoid getting points on her licence for speeding in her car is in breach of the requirement of probity. A doctor who takes illegal drugs is also breaching the probity ethic. Serious breaches of probity can lead to being struck off the medical register.

Probity is vital in a good doctor because doctors need to earn the trust and respect of the public. Some patients will not come to a doctor who has a reputation for dishonest and unethical conduct. Some who come to such a doctor will not speak candidly about embarrassing matters. 

Under highly unusual circumstances breaking medical confidentiality might be permissible. If a married man tests positive for HIV he should be encouraged to inform his spouse. If he refuses to do so then the doctor will have to do so to reduce the risk that the spouse will contract an incurable and terminal illness. This can only be done for grave illnesses.

In an emergency situation a doctor might have to tell another doctor or a nurse something such as the patient is a haemophiliac. This is so appropriate treatment can be provided. It is not done simply because people want to gossip. 

If a patient reveals something indicative of child abuse – whether sexual or physical – then the doctor must inform the police and social services. If he notices that a girl has suffered female genital mutilation then he or she must disclose this even without the consent of the patient. Pursuant to police investigations medically confidential information can be shared with the police if there is a court order to do so. 

Even revealing a patient’s age can be a breach of confidentiality. Patients can be very touchy about this. 

Doctors can of course disclose confidential medical information with the express permission of patients. That is not a breach of confidentiality. That is a normal thing to do in the course of professional practice. 

About Calers

Born Belfast 1971. I read history at Edinburgh. I did a Master's at UCL. I have semi-libertarian right wing opinions. I am married with a daughter and a son. I am allergic to cats. I am the falling hope of the not so stern and somewhat bending Tories. I am a legal beagle rather than and eagle. Big up the Commonwealth of Nations.

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