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Background reading material for Year 2 Semester 2 med PPSD session on Wednesday 04th February 2009 by Professor Omar Hasan Kasule Sr.
1.0 JUSTIFIED INFORMATION RELEASE WITHOUT CONSENT
1.1 Release to other health care workers: Information has to be released to other health care givers in the process of clinical management. Consent in such a situation is implied and there is no need to seek any special consent from the patient.
1.2 Legal requirements and the Public Interest: Information release may be required by statute such as reporting notifiable diseases. In some situations public interest may necessitate information release. Information can be released in the public interest to protect the public from infection or from violence even if the patient withholds consent. Crime investigation may justify information release. Judicial proceedings may require release of information to ensure justice. In cases of court litigation, the caregiver could testify in criminal cases There are situations in which over-riding public interest will require refusing to release information even if the patient consents.
2.0 UNJUSTIFIED RELEASE OF INFORMATION WITHOUT CONSENT
2.1 Education, research, medical audit are not situations of necessity that justify violation of confidentiality. Information can be released only if the patient consents. Information release can be allowed if the information is anonymous or is an aggregated form such that no individual patient can be identified.
2.2 Employers or insurance companies may require medical information in order to make certain decisions. These are not considered situations of necessity that justify violation of confidentiality. There is no difference in the Law between disclosure during life or after death of the patient. One of the ways for the caregiver to decrease his risk of revealing secret information is to have only the minimum needed for his work. This means that during history taking only those questions directly related to the medical problem should be asked. There should be no probing or digging for unrelated facts.
2.3 Divided or conflicting loyalties
Some physicians find themselves in a situation of conflict and divided loyalty. A company physician is obliged to report to his employers that will violate the confidentiality between him and his patients. Military physicians may also have to report medical information to the higher brass. The physician may have to make a notification to relevant authorities when he believes that there is serious danger to third parties for example HIV positive cases who share needles or epileptic drivers. Parents who abuse their children may have to be reported. It may be necessary to notify a spouse in case of HIV infection.