M09.03.010 Patient Confidentiality

Patient confidentiality is a fundamental principle in healthcare, ensuring that private information shared by patients is kept secure and not disclosed without consent. This document outlines the importance of patient confidentiality, the obligations of healthcare providers, exceptions to the rule, and guidelines for specific situations.

Importance of Patient Confidentiality

• Trust Building: Confidentiality is essential for establishing and maintaining a trusting relationship between the physician and the patient.
• Legal Obligations: Healthcare providers are legally and ethically bound to protect patient information.

Key Responsibilities of Physicians

1. Protection of Patient Information:
   • Ensure conversations about patient care are held in private settings.
   • Maintain the security of both physical and electronic medical records.
2. Access to Records:
   • While healthcare providers own medical records, patients have the right to access or obtain copies upon request.
3. Court Subpoena Protocol:
   • Appear in court if subpoenaed but refrain from disclosing patient information without proper legal authority.

Exceptions to Patient Confidentiality

While patient confidentiality is crucial, there are specific circumstances where disclosure is permitted or required:

• Duty to Warn and Protect (Tarasoff Case):
  • If a patient poses a threat to themselves or others, confidentiality may be breached to warn and protect potential victims.
• Mandatory Reporting:
  • Disclosure may be necessary for:
    • Specific threats to identifiable individuals.
    • Cases of suicide, homicide, or child/elder abuse.
    • Reporting infectious diseases to public health authorities.
    • Notification of impaired drivers to the appropriate authorities.

Guidelines for Handling Inquiries

Points to Remember

• Patient confidentiality is a legal and ethical requirement.
• Breaching confidentiality can lead to a loss of trust and damage the physician-patient relationship.
• Always ensure that sensitive information is discussed in private settings to prevent unauthorized access.
• Be aware of legal obligations when faced with court subpoenas.
• Understand the exceptions to confidentiality, particularly in cases of imminent harm.

Bibliography

1. Tarasoff v. Regents of the University of California. 17 Cal. 3d 425, 551 P.2d 334, 131 Cal. Rptr. 14 (1976).
2. American Medical Association. (2021). Principles of Medical Ethics. Retrieved from AMA Ethics
3. U.S. Department of Health and Human Services. (2013). Health Insurance Portability and Accountability Act (HIPAA). Retrieved from HHS HIPAA