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Presentation
at a training program ‘Applying the Principles of Ethics to Clinical
Practice:’ held at Aramco Dhahran April 6, 2015 by Professor Omar Hasan
Kasule Sr. MB ChB (MUK). M{H (Harvard), DrPH (Harvard) Chairman of the Ethics
Committee King Fahad Medical City.
1.1 Privacy and confidentiality are often confused.
·
Privacy is the right to personal or private matters and blocking access
to private information.
·
The patient voluntarily allows the physician access to private
information in the trust that it will not be disclosed to others which creates
a duty of confidentiality.
·
Confidentiality must be maintained within the confines of the Law even
after death of the patient.
1.2 Keeping confidentiality
·
In routine hospital practice, many persons have access to confidential
information but all are enjoined to keep such information confidential.
·
The patient should not make unnecessary revelation of negative things
about himself or herself.
1.3 Breaching confidentiality
·
The physician cannot disclose confidential information to a third party
without the consent of the patient.
·
Information can be released without the consent of the patient for
purposes of medical care, for criminal investigations, and in the public
interest.
·
Release is not justified without patient consent for the following purposes:
education, research, medical audit, employment or insurance.
Discussion Case #1:
A neurologist informed his wife over dinner about an
elderly school bus driver who had Parkinson disease and had to take an
unusually high dose of medication to suppress the tremors. The medication made
the patient sleepy all day. The wife asked for the name and realized that the
patient was a driver for her school transport company who had been coming to
work late in the past 2 weeks. She dismissed him the next morning.
Discussion Case #2:
The manager of a national airline was worried about
the erratic behavior and mistakes of one of the senior pilots. He asked around
and found out the name and address of the pilot’s family doctor who was in
private practice. He wrote to the private practitioner to provide records about
treatment of the pilot for vision and psychological problems. He asked
specifically for information on drug abuse. The private practitioner called and
gave the information but told the manager that he could not put it down in
writing since he had not discussed the matter with the patient.