L 16 Patients' Confidentiality

Patient ConfidentialityProf. Faisal Ghani Siddiqui

MBBS; FCPS; PGD-BIOETHICS; MCPS-HPE

Preamble• What is confidentiality?• Why confidentiality is important?• How to maintain the confidentiality of

our patients’ information?• When to disclose medical information?

What is Confidentiality?

It is the assurance to the patient that the information (s)he shares with doctors would not be passed on to anyone without their permission

What is confidentiality?

. . . And such information can be shared only after authorization is provided, and then only with authorized individuals.

What is confidentiality?

What information should be kept secret? Any medical information that comes to the knowledge of the practitioners as a result of their work, whether directly obtained from the patient, or otherwise

What information should be kept secret? • Past, present or future physical/mental

condition• Diagnosis or treatment• Photograph, video, audiotape • Patient’s doctor’s name(s) • Clinics patient attended • The past, present, or future payment for the

healthcare to the individual

Why Confidentiality is important?

Why Confidentiality is Important?

If patient knows his/her information will be kept secret

)S(he will render important information to the doctor

Good diagnosis

Better treatment

AreConfidentiality & Privacy similar?

ConfidentialityPersonal information shared with a doctor that cannot be divulged to anyone without the consent of the patient

PrivacyFreedom of the patient not to give information to the physician

HowConfidentiality Should be Maintained?

Sharing of Information• Do not discuss patient’s medical

information with unauthorized family members

• Limit sharing of information with other staff, unless for consultations and second opinion

• Do not disclose patient’s information without his/her consent

Patient’s Manual Records• Hold in secure place under lock and key• Return to the filing system as soon as

possible after use

Electronic Records• Log out computer system when work is

finished• Do not leave a terminal unattended while

logged in• Do not share passwords with others• Change passwords at regular intervals• Always clear the screen of previous

patient’s information before seeing another

Emails & Fax• Whenever possible, clinical details should

be separated from demographic data;• All data transmitted by email should be

password-protected

When Confidentiality can be breached?

When confidentiality can be breached?• Permitted by the patient or substitute

decision maker• If required by judiciary • Consultation or second opinion• Public health interest/threats (birth, death,

notifiable diseases)• Individual’s threats to prevent crimes

When confidentiality can be breeched?• If needed by the doctor to defend

him/herself before judges or disciplinary committee

• If the patient consciously and truly admits committing a crime on which another person was accused/punished

Fiqhi Aspectsوتخونوا" سول والر ه الل تخونوا ال آمنوا ذين ال ها أي يا

تعلمون ( وأنتم )”27أماناتكم

عليه الله صلى بي الن عن عنه الله رضي جابر عن )) : فهي التفت ثم بالحديث الرجل حدث إذا قال وسلم،

االلباني))  وحسنه والترمذي داود أبو رواه أمانة

When 4 conditions are fulfilled!• What was disclosed was a secret• The actual disclosure regardless the way of

disclosure• To be the person trusted to keep the secret• The intention to disclose e.g. not out of negligence

or forgetting, (leaving the records open or accidently dropping a medical information sheet)

When Disclosure of Medical Secret Considered a Crime?