medskl.com is a global, free open access medical education (FOAMEd) project covering the fundamentals of clinical medicine with animations, lectures and concise summaries. medskl.com is working with over 170 award-winning medical school professors to provide content in 200+ clinical presentations for use in the classroom and for physician CME.
Legal and Ethical Aspects of Medicine – Confidentiality
Whiteboard Animation Transcript
with Nelson Chan, MD, LLB
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:
1. Most breaches are inadvertent
You 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.
2. Confidentiality applies to individuals, not families
It 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.
3. There are exceptions to confidentiality
The 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.
