Medicine & Ethics

The Weight of Patient Confidentiality in the Medical World: Why the Need to Report a Situation Trumps Over the Principle.

By Rachel Prince, YouthCare Connect

Patient confidentiality is the practice of physicians protecting identifiable patient information from disclosure. However, certain situations definitely push this ethical ideal and make healthcare providers question—would it be safer to report the situation or to maintain patient confidentiality? The patient-physician bond describes how a patient is entitled and expected to have a confidential experience, and therefore, gain a sense of trust from their healthcare provider. However, if a patient has disclosed information which may put others in danger, a physician must choose to prioritize safety rather than an individual patient’s rights.

The Influence of the Past: the Hippocratic Oath.

Patient confidentiality dates back to 2,500 years ago when the Hippocratic Oath was created by Greek philosophers to preserve this practice for future physicians. This practice is still used today in the modern medicine world (Moskop). Physicians protect patient privacy and only provide information with the patient’s consent. This has become known as a basic professional responsibility that all physicians follow.

The Issue with Patient Confidentiality:

In certain cases, it may be necessary to break patient confidentiality. For example, if a patient comes in and later reports their cocaine use as a way to relieve stress, a doctor is posed with the decision of either reporting the patient to the police or letting them go and upholding the ideal of patient confidentiality. Even though this has been a long-practiced ideal in the medical world, there are certain restrictions which can cause physicians to fall into a dilemma (Alfandre). However, even if there is a situation where doctors must break patient confidentiality, they’re only allowed to disclose the minimum and necessary information.

A Perspective from India:

Farhad Kapadia, a doctor in Mumbai, states that when he is faced with a situation which questions patient confidentiality, he questions if the public interest is in danger, and then continues to make decisions. In Kapadia’s case, he tries his best to avoid alerting the police, to prevent any harassment towards the patient, the family, and the person in danger. He explains that from an ethical perspective, it’s important to reason with the patient first before jumping straight to a conclusion. If the patient does decide to refuse, then he informs them that the police will be reported, this is the last resort (Cotton). In any case, the patient is alerted of all their options and consequences before they are acted upon.

Patient confidentiality is a topic that’s constantly being wrestled with because of the numerous debates surrounding it. But why must there be a debate on the protection of the public. It may seem like a dilemma, but when one life is possibly putting numerous lives in danger, would it be a good decision to waste time thinking?