The laws of most countries regulate the confidentiality of information in the field of law, education, insurance, business, credit and medicine. Back in the III century BC. e. there was such a thing as "medical secret." The text of the Hippocratic oath about the information received during treatment about the patient says: "I will keep silent about this, considering such things a secret."
The laws governing the confidentiality of medical information in different powers have some differences. However, a citizen of any civilized state has a certain right to non-disclosure of personal information. And for violation of this right, the legislature provides for a penalty in the form of a fine, correctional labor, or other measures.
Medical Ethics and Privacy
Medical ethics, which regulates the doctor’s relationship with the patient and colleagues, includes the principle of respecting the views, religious beliefs and preferences of the patient, as well as maintaining medical confidentiality, including his personal information. What information received by the doctor from the patient, in accordance with ethical and legal standards, is forbidden to disseminate?
The doctor must keep secret the fact of a person contacting him for help. He must not allow anyone to know any information received from the patient’s mouth: bad habits, family and intimate life, etc. He also cannot divulge test results, diagnosis and prognosis. At the same time, the doctor undertakes not only not to be a carrier of such information, but also to ensure that no one has access to such information contained on paper or electronic devices.
Some features
Information constituting a medical secret must be confidential, regardless of whether the patient asks for it or not. Medical secrets are preserved, for example, in the case when a person is not issued a special medical certificate due to his illness. State secrets, for example, cannot be the subject of a person’s work with mental disabilities. An individual with such deviations will not receive such a document, however, the reason for this will remain unknown to anyone except himself.
The transfer by a doctor of information about the diagnosis and treatment of a patient to his colleagues for consultation in order to provide quality medical care is not an unlawful act. However, the obligation to keep medical confidentiality rests with all doctors involved in the medical process. Discussion of therapy for specific patients between doctors is unacceptable in the presence of strangers.
Disclosure of medical confidentiality with the consent of the patient
There are times when a patient can express his consent to the dissemination of some information about him. Information may be required for further examination and treatment of the patient, for its use in the educational process, for conducting scientific research, etc. Permission to disclose information that is legally confidential is provided only with the written consent of the patient, certified by his own signature. If the patient is incapacitated, written consent is allowed to be drawn up by his legal representative. The latter can be appointed exclusively through the court.
Disclosure of medical confidentiality without the consent of the patient
The law establishes that some situations may cause the doctor to provide confidential information about the patient without his oral or written consent. Such exceptional cases are:
- danger of infection, poisoning or damage to others;
- investigation of the crime;
- suspicion of unlawful actions against the patient;
- conducting medical examination;
- the patient's inability to express his will;
- assistance to persons under 15 years of age.
Even if the written consent is not required to provide information about the patient to third parties, the doctor must inform him of the disclosure of this information.
When is pre-investigation check, the doctor has no right to disclose patient information to law enforcement agencies. Only an official request from law enforcement gives such a right. The request must be made in writing, and the amount of necessary information is strictly limited.
Medical privacy goal
If the patient is sure that all the information presented by him is a medical medical secret, he will be prone to frankness and will not hide information important for the implementation of high-quality treatment. A trusting relationship will develop between him and the attending physician, which will certainly contribute to the success of the treatment process.
If such an information transfer occurs - medical secrets are disclosed to third parties - this often threatens the patient's social status. A significant obstacle in a person’s social self-affirmation can be the dissemination of information about his mental or emotional problems, oncological, genetic or sexually transmitted diseases, etc. This can also become an obstacle to his career advancement and cast doubt on success in other areas of life. A doctor who cares so that the disclosure of medical secrets does not happen in any case, gains the trust of patients. Over time, he gains a reputation as a reliable specialist for whom the personal interests of patients are above all.
Medical Secret Difficulties
A lot of questions are connected with the concept of “medical secret”. The law of a country ensures the right of the patient to keep information about his health in strict confidence and regulates its transfer to third parties. However, in practice, there are many other situations - in relation to them in the law there are no clear requirements. In other cases, it may turn out that for the patient’s emotional state, acting strictly according to the requirements of legal acts is not the best option.
For example, is it necessary to keep secret information about a mental illness of a person who, due to his illness, can harm others? Is it worth keeping his patient's sexually transmitted disease or HIV infection secret, because such information can keep them healthy? Is it always necessary to act according to the law, if a patient finds an incurable disease? Or, in some situations, it is better to inform his family about this instead of the patient? All these issues often present enormous complexity for medical professionals.
Medical Secret Laws
In Russia, the concept of medical confidentiality is described in the Federal Law. It is considered an important health principle. The same law contains a listing of situations in which disclosure of confidential medical facts without the consent of the patient is not unlawful. The human right to the safety of his personal information is guaranteed by Articles 23 and 24 of the Constitution of the Russian Federation, Article 137 of the Criminal Code of the Russian Federation. Specifically, medical confidentiality is prescribed in Art. 62 "Basics". In Ukraine, the Civil Code, “Fundamentals of the Ukrainian legislation on health care”, and the laws “On Information” regulate the issue.
In Russia and Ukraine, as in all countries of the post-Soviet space, there are many legislative acts reflecting one side or another of the question of how professional medical secrets should be kept. Any doctor must be aware of the rights of his patients guaranteed to him by the law of his power.
Patient's right to health information
When it comes to medical secrets, it is always implied that the information remains secret between the patient and the doctor. The doctor has no right not to inform his patient about his health condition. Everything that a doctor knows should be known to man. However, the information must be conveyed to the patient in such a way that he has a concrete idea of his disease and the treatment prescribed to him. However, if a person does not want to be informed about the state of his health, you can not forcibly inform him about it.
In many European countries, all patient medical records are the undisputed property of the clinic involved in its treatment. A person has the right only to familiarize themselves with them. In some states of the post-Soviet space, at the request of the patient, all documents relating to his health or their photocopies can be issued to him.
Responsibility for non-observance of the principle of confidentiality
For disclosure of medical secrets, the culprit may be punished with varying severity. Much depends on the damage caused to the victim by the incorrect actions of the doctor. As a result, the dissemination of personal information, a person can be traumatized, suffer economically or even resort to suicide. The transfer of medical secrets to third parties may result in a reprimand for the health worker, payment of a fine, forced community service and removal from office. In some cases, the perpetrator of the crime is awarded participation in correctional labor or imprisonment.
Who else is required to keep medical confidentiality
Doctors of absolutely any specialization cannot neglect such an ethical and legal concept as “medical secret”. The law, however, indicates that not only doctors can be responsible for disseminating confidential information in this area. The obligation to preserve medical secrets also lies with nurses, paramedics, pharmacists, orderlies, nannies, employees of medical treatment centers, insurance workers, students. In a word, this principle applies to everyone who received such information as a result of the performance of their job duties.
Is HIV information secret?
As already noted, not every ongoing treatment program should remain confidential. Medical secrets should not include information about a patient who may become a source of infection for other people. Such individuals need to urgently be isolated from others and, possibly, to inform a wide circle of people about the existing case of infection in order to prevent an epidemic.
However, HIV infection is not one of the human diseases that a doctor can report to others without breaking the law. With caution, a person with HIV infection can prevent infection from others around him. Therefore, the presence of this ailment in the patient, the doctor must keep secret.
Medical ethics for the hopelessly sick and dead
Contrary to the fact that many doctors, out of pity for the patient, report his disappointing prognosis not to him, but to his family, such an act is against the law. Any person has the right to be the first to know his diagnosis, only he can decide who should be informed about him. However, in practice, everything is very complicated, because after learning about his hopeless situation, the patient may lose heart and not resist his illness in any way.
As for those patients who have already died, some information about their health should also be kept secret. Despite the fact that they are no longer alive, the surfaced information can affect the memories that others have about them. Thus, we can say that medical confidentiality has no time limits.
What to do if your right to confidential information is violated?
If your medical secret was disclosed and there are witnesses to this crime, you must write a statement to the department of the Investigative Committee. It should indicate your data, the diagnosis put to you (with the application of supporting documents), where you are registered. Then you need to indicate who you have dedicated to information about your illness and why you did not want anyone else to know about it, what consequences you feared. In continuation, describe the situation in which your secret of medical information was revealed. Please indicate in detail all the consequences that this offense had for you, asking you to initiate a criminal case against the offender. List all the details of witnesses to the crime, including their addresses and phone numbers. If the court finds the health worker guilty, you will be paid moral compensation.
Divulging medical confidentiality is a crime. The legislation of each country of the world has provided for a number of laws protecting the rights of its citizens to the confidentiality of personal information. Unfortunately, a violation of this right in practice is not always easy to prove. If you urgently need to keep some medical information about yourself secretly, urgently ask your doctor about this, having mentioned several laws in force in the country that regulate this issue.