Legal and Ethical Aspects of Medicine – Confidentiality: By Nelson Chan M.D.

Confidentiality is a key component of the
patient-physician relationship. Patients who believe that their health information
will remain confidential are more likely to provide doctors with more accurate information,
which in turn will lead to better medical advice. Here are 3 things you cannot forget about
confidentiality: Most breaches are inadvertentYou may encounter
a particularly challenging case that you want to share with your colleagues. That is okay, as long as you don’t disclose
information that can reasonably lead to the identity of the patient – like name, initials,
prominent family members, or occupation (if unusual). You should also refrain from sharing cases
on social media, especially those that might be on the news, as you can easily lose control
of who sees this information once posted. Confidentiality applies to individuals, not
familiesIt is not uncommon for physicians to care for multiple family members. This can be very rewarding but also fraught
with ethical dilemmas. What if your patient asked you why you prescribed
birth control pills to her 15-year-old daughter? Or what if you received a request from an
insurance company for your patient’s family history after you recently diagnosed his father
with coronary artery disease?With few exceptions, you can only disclose medical information
with your patient’s implied or express consent and the information disclosed should have
been collected directly from that patient. There are exceptions to confidentialityThe
law recognizes specific situations where you need to disclose information for the greater
public good. An example of mandatory reporting is when
you suspect that a child is in need of protection. There are also situations where it is permissible
for a physician to report to governmental agency – for instance in the situation in
which a patient demonstrates to you that he or she will likely inflict serious harm on
a specific person or group of persons.


  1. Soik has to go abroad to receive treatment because the local police distributed details of his criminal past to all doctors and chemists. In his own country he has to register with a drug clinic or pay a high bill to a private doctor who is not intimated by 40 yr old gossip. This is England. Soik believes that a major breach in doctor patient confidentiality has occurred but here in the UK social class is everything. Freedom in the UK is frowned upon.

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