Confidentiality

"And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets..." (20).

"...I will respect the secrets which are confided in me, even after the patient has died ." (21).

"...A physician shall preserve absolute confidentiality on all he knows about his patient even after the patient has died..." (22).

Information acquired by a medical practitioner from or about a patient in the course of his or her professional work is confidential and must never be disclosed to others without either the consent of the patient or other proper justification.

Confidentiality is primarily a professional conduct matter for the medical practitioner, but patients also have a legal right to confidentiality, protected by law. The GMC in the United Kingdom and other medical councils and medical boards worldwide have published guidance to doctors, making it clear that a breach of confidentiality is a serious professional offense. The GMC's current guidance (23) requires doctors to:

"Treat information about patients as confidential. If in exceptional circumstances there are good reasons why you should pass on information without a patient's consent, or against a patient's wishes, you must follow our guidance "Confidentiality: Protecting and Providing Information" and be prepared to justify your decision to the patient, if appropriate, and to the GMC and the courts, if called upon to do so."

A separate GMC booklet (24) sets out more detailed guidance, including the principles of confidentiality and exceptions to the general rule.

Doctors are responsible for the safekeeping of confidential information against improper disclosure when it is stored, transmitted to others, or discarded. If a doctor plans to disclose information about a patient to others, he or she must first inform the patient of that intention and make clear that the patient has an opportunity to withhold permission for its disclosure. Patients' requests for confidentiality must be respected, except for exceptional circumstances, such as where the health or safety of others would otherwise be at serious risk.

If confidential information is disclosed, the doctor should release only as much as is necessary for the purpose and must always be ready and willing to justify the disclosure—for example, to the relevant medical council or board or to the courts. Where confidential information is to be shared with healthcare workers or others, the doctor must ensure that they, too, respect confidentiality.

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