Why Is Doctor-Patient Confidentiality So Important?

Anything said within your doctor’s surgery should remain between the two of you. But when can a doctor rightfully disclose personal information? And what happens if a family member is diagnosed with a condition to which you could fall prey? We discuss the principles and dilemmas involved in doctor-patient confidentiality.

The Confidentiality Principle

Doctor-patient confidentiality is simple: as a patient you have a right to complete confidentiality. Anything said within the confines of a clinic surgery, or treatment room becomes protected under the Data Protection Act. This includes the fact that you were even there. Doctors have no right to supply anyone, even close family members, with your medical records or information. Mothers cannot obtain information on their children (without their consent) and doctors have no obligation to inform parents about teen pregnancies either. Privacy is an important issue.

“Many young people mistakenly believe that after they've been to the doctor for contraception, a sexually transmitted infection check or a pregnancy test, the first thing the doctor will do is phone their parents,” says Dr Rob Hicks (BBC). “This isn't true. The doctor can’t break her confidentiality.”

Doctor-patient confidentiality means that everything a patient says and asks of the doctor remains completely secret. Your diagnosis and prescription will, however, be noted on your medical records (see our article on Medical Records for more information).

In order to give you an effective treatment, your medical records might also be shared between healthcare professionals; but the information is usually non-identifiable, unless it is being passed to a specialist for consultation. It is assumed that you permit this type of disclosure, so patient consent isn’t explicitly sought. However, if you do not want your information shared with anybody at all, you have the right to request this: your doctor will make you aware of the implications (fewer treatment options, and so on)but respect your privacy.

Exceptions to the Rule

Patients are occasionally asked to consent to the disclosure of their information, but this would usually be for the purposes of research or case studies. For the sake of privacy, doctors must be clear about the nature and scope of the disclosure before patients sign their consent.

Without explicit consent, patient confidentiality can be breached for any of the following reasons:

• If there are reasonable grounds (to protect the patient, their family, or community)

• If it is considered democratically necessary (particularly where it might affect others)

• If it is proportionate to the need.

These clauses are designed to protect people who could suffer from non-disclosure: for example, a doctor might inform a patient’s partner that (s)he has HIV, or (s)he might pass on information that prevents an unfit patient from driving. It would be necessary for any health professional to seek approval before making a decision on such disclosure.

The Health Secretary sparked debate recently when she expressed concern for the Muslim women in her constituency who were unable to trust their GPs. Patricia Hewitt told a magazine that Muslim women had spoken to her at length about the privacy problems with living in a close-knit community where nothing was secret. Although many Muslim and non-Muslim GPs leapt to defend the profession, it was acknowledged that close communities, made up of networks of extended families, often fail on privacy issues.

More About Doctor-Patient Confidentiality

Make sure you read our articles about Genetic Privacy, NHS Privacy, and Your Medical Records. The Department of Health’s Code of Practice for healthcare professionals and GPs is available online.