chapter  5
20 Pages

CONFIDENTIALITY AND MEDICAL RECORDS

The duty of confidence requires that doctors must keep information about their patients secret. This duty has a long history and is part of the Hippocratic oath:

The Declaration of Geneva 1948 (amended at Sydney, 1968) is a modern, international version of the Hippocratic oath and states: ‘I will respect the secrets which are confided in me, even after the patient has died.’ The main ethical theories also support the duty of confidence. From a utilitarian viewpoint, patients are more likely to give information to doctors if they know that they have a duty of confidence, and this leads to better overall health for the population at large. From a deontological (or duty-based) point of view, the principle of respect for autonomy requires a doctor to keep information about patients confidential. The effect of the Human Rights Act 1998 means that Art 8 of the European Convention on Human Rights (the right to respect for private life) will require a person’s medical records to be kept private. Professional codes produced by medical and nursing bodies require members to keep information about patients obtained in the course of their work confidential. The common law rules also require information obtained in certain circumstances to be kept confidential. The common law rules were not developed specifically with regard to medical information but apply generally. In addition, under the Data Protection Act 1998, health professionals must keep health records private, whether they are held on a computer database or in manual files. Under the Freedom of Information Act 2000, which came into force on 1 January 2005, health records are exempt from disclosure.