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Background material by Professor Omar Hasan Kasule Sr. for Year 2 Semester 2 Med PPSD session on Wednesday 21st January 2009
Clinical care
If the patient is not assured that information revealed to physicians will be kept in confidence, he or she will not provide sufficient information to the physician for proper diagnosis and management. Such violation destroys future co-operation because the patient will hold back some information from the caregiver thus impairing correct diagnosis and appropriate management.
Autonomy and privacy
The patient has a right to keep personal information private and inaccessible to unauthorized persons.
Fidelity
It is part of the trust between the patient and physician that their professional relationship remains private. The psychological basis of fidelity is the private and privileged relationship of trust between the patient and the caregiver. Revealing secrets that occurred to a third party is a violation of the trust. If a person seeks advice and divulges secret information, that information is protected because the advisor is supposed to be trusted
Social basis: prohibition of rumors
The social basis lies in the prohibition of spreading rumors, and backbiting.
Legal basis: contract
The legal basis is based on the law of contract, three Principles of the Law, and the Law of Property. Keeping medical secrets is part of the physician-patient contract; fulfilling a contract is an obligation in Islam. Revealing secrets injures the reputation of the patient and violates the Principle of Injury which states that an individual should not harm others or be harmed by others. Under the Principle of Hardship confidential information can be revealed in cases of necessity. The Principle of Hardship states that hardship mitigates easing of the rules and obligations. Necessity legalizes the otherwise prohibited. Therefore for purposes of treatment, information can be revealed to other healthcare workers. Information can also be revealed in pursuit of justice.