The obligation of the doctor to maintain patient’s confidentiality is one of the fundamental tenets of health care. This obligation is held in high regard and it is articulated in many modern codes of medical ethics such as the American Medical Association and the British Medical Association.
Health care professionals therefore go to great lengths to protect confidential information provided by the client. Even so, there are cases where doctors may reveal information provided in confidence without the patient’s consent. This paper will argue that such cases are justifiable since there are instances when patient confidentiality should be broken. To reinforce this claim, some of the scenarios were such breaches are acceptable will be illustrated.
In some cases, disclosure even without the consent of the patient is necessary to prevent harm to others. The General Medical Council (2009) advices that personal information may be disclosed if this disclosure will help protect individuals or society from risks such as those posed by communicable diseases. For example, if a patient has a Sexually Transmitted Infection and refuses to inform a sexual partner, the doctor has an obligation to break confidentiality.
Confidentiality can also be broken if doing so will benefit other members of the society. For example, if a patient is found to be suffering from a treatable inherited disorder, the relatives should be informed even if the patient refuses (Kuhse & Singer, 2009). This is because this information will lead to the relatives being screened and treated for the disease. In the two cases highlighted above, the benefits to other members of the society far outweigh the patient’s interest in preserving confidentiality.
Another instance where it may be necessary to break confidence is when the patient is a victim of violence. Even if the patient insists that the doctor keep the information secret, it may be in the patient’s best interest that confidentiality be broken since it may assist in the prevention or prosecution of the individual who perpetrated the serious crime against the patient (General Medical Council, 2009). By breaking confidence, the physician can help to prevent further crimes from being committed.
Kuhse and Singer (2009) declare that in order for doctors to do a good job for their patients they often require information of a sort that is generally regarded as private. Patients are unlikely to pass on such information without the assurances of confidentiality. It can therefore be seen that without confidentiality, patients may be reluctant to give health care personnel relevant information which may be necessary for the provision of good care.
While respecting the patient’s confidentiality is of fundamental importance in health care, it is not considered to be an absolute obligation (Kuhse & Singer, 2009). This reveals the acknowledgement by medical practitioners that there may be times when it is necessary to break patient’s confidence.
While confidential is central to the establishment of trust between health care practitioners and patients, this paper has demonstrated that it may at times be necessary to break this confidence. In particular, this paper has documented that when the patient’s right to confidentiality is in conflict with an overriding duty to society, the doctor has a duty to break the patient’s confidentiality. Even so, the doctor must strive to preserve patient’s confidentiality at all times since without it, it may be hard to provide quality care to the patient.
General Medical Council (2009). Confidentiality Guide. Retrieved from: http://www.gmc-uk.org/guidance/ethical_guidance/confidentiality.asp
Kuhse, H. & Singer, P. (2009). A Companion to Bioethics. NJ: John Wiley and Sons