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5 - Confidentiality, privacy and disclosure

Kerry J. Breen
Affiliation:
National Health and Medical Research Council
Stephen M. Cordner
Affiliation:
Monash University, Victoria
Colin J. H. Thomson
Affiliation:
University of Wollongong, New South Wales
Vernon D. Plueckhahn
Affiliation:
Monash University, Victoria
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Summary

Fundamental to a proper doctor–patient relationship is the assurance that information provided by the patient to the treating doctor will remain strictly confidential. Doctors must be free to ask their patients any questions necessary for diagnosis and treatment, and patients must be willing to trust doctors by giving full answers. Maintaining such trust has a wider social benefit of ensuring that medical practice serves to promote and maintain the health of the community. The basis of this trust lies in one of the oldest ethical principles of medical practice stated in the Hippocratic Oath as:

whatsoever I shall see or hear in the course of my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets.

This same obligation has since been repeated in the World Medical Association Declaration of Geneva as ‘I will respect the secrets confided in me, even after the patient has died’.

This ethical requirement for confidentiality, well understood by doctors, has been overlaid in Australia in recent years by the progressive introduction of privacy legislation at the federal level and in some states, which for doctors covers very much the same territory as this ethical requirement. As a result, doctors now need to understand the ethical and legal bases of their professional obligations in this regard. In this chapter, both bases are described and explained.

Type
Chapter
Information
Good Medical Practice
Professionalism, Ethics and Law
, pp. 69 - 86
Publisher: Cambridge University Press
Print publication year: 2010

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References

Hippocrates, . Hippocrates. Jones, WHS, translator. Harvard University Press, Cambridge, 1968, Vol. 1.Google Scholar
,World Medical Association. Declaration of Geneva 2006. www.wma.net/e/policy/c8.htm
,Federal Privacy Commissioner. Public Interest Determination 10. Collection of Family, Social and Medical Histories. http://www.privacy.gov.au/publications/pid10.html
AMA Code of Ethics – 2004. (Editorially revised 2006.) www.ama.com.au/web.nsf/doc/WEEN-6VL8CP (accessed March 2008)
,Medical Practitioners Board of Victoria. Good Medical Practice. www.medicalboardvic.org.au/pdf/Good%20Medical%20Practice.pdf
Gerber, P.Confidentiality and the courts. Med J Aust 1999; 170: 222–4.Google ScholarPubMed
Herdy, W.Must the doctor tell?J Law Med 1996; 3: 270–81.Google Scholar
,Australian Medical Association. Privacy Resource Handbook for all Medical Practitioners in the Private Sector. Australian Medical Association, Canberra, 2002.Google Scholar
,Medical Defence Association of Victoria. Medicine and the Law: A Practical Guide for Doctors. Medical Defence Association of Victoria, Carlton, Victoria, 2006.Google Scholar
,Office of the Federal Privacy Commissioner. New Privacy Law and the Private Health Sector. Office of the Federal Privacy Commissioner, Canberra, 2001.Google Scholar
Braunack-Mayer, AJ, Mulligan, EC. Sharing patient information between professionals: confidentiality and ethics. Med J Aust 2003; 178: 277–9.Google Scholar
Otlowski, MFA. Disclosure of genetic information to at-risk relatives: recent amendments to the Privacy Act 1988 (Cwlth). Med J Aust 2007; 197: 398–9.Google Scholar

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