Table of Contents
The issue of the confidentiality of the patient’s records has elicited different reactions in the contemporary society. Patient confidentiality, to begin with, is an essential ingredient in building the trust between the patients and their doctors. The fact that the patient is assured that whatever information he will share with the doctor won’t be shared with any third party enables the patient to open up and give the doctor information that he would otherwise prefer to be undisclosed (Courtney Mathews 720). However, the society, as well as the family members of the patient, often feel they should be permitted to breach the confidentiality and the information relating to the patient be disclosed to them. The family can also seek the disclosure of the information of the patient especially when the patient passes on. Such situations have been a challenge to the health care professionals who often have to decide on whether they should disclose the medical records to the family or not.
The respect of confidentiality is of importance in protecting the well-being of the patients and in the assurance of the trust and confidence in the doctor-patient relationships. The inappropriate disclosure of such information concerning the patient’s well-being can lead to loss of opportunities, financial commitments, personal humiliation and also tamper with the patient’s reputation. This obligation is strict but not indefinite. There are cases when the doctor-patient confidentiality can be breached or limited. Take an example: Mary an eight-year-old girl has been consistently raped with his step brother for about a month, during one of the counselling session she opens up to the counsellor on the matter which can be categorized as a statutory rape considering Mary is below the concession age. Other cases of clinical breaches of include: when the patient is a risk to the people around him and him when it’s a matter in the court when the issue involves the violation of human rights, and the patient is transferred to another health facility.
Breaches after a discovery of the violation of human rights. When the doctor examines the patient and establishes that to an extent the patient has been abused. The abuse can take physical sense or sexual sense. This breach is often common when a minor is involved. In this case, the practitioner can share the information with the guardians and parents of the minor; the authority can also be involved when the impact of the abuse is severe, and the child doesn’t know what to do. The breach, in this case, can be said to be just. Going by the principles of the health practice, all the actions of the practitioner should aim at benefiting the patient and the patient alone, and if to offer the services that are required involves breaching the confidentiality clause then it’s a justified breach.
The principle of confidentiality can also be breached if the patient is a threat to himself as well as the general population. For instance, during a counselling session, the patient confesses to planning a terrorist attack on the country. Another patient who is suffering from HIV/AIDS confesses her intention to infect many men by seducing them into the sensual act. In such as case, the doctor has to notify the relevant law enforcement urgencies and the AIDS prevention units respectively. This breach of confidentiality is justified since it protects the patient as well as the people around him. Such breaches of confidentiality have been instrumental in the reduction of suicide cases in the world.
When a court order or a valid subpoena has been issued to disclose the patient information when the patient is involved in a criminal act. In this case, the health practitioner will have no option but to provide the judiciary officials with the records. This breach is often common in cases related to mental illnesses where the patient committed a heinous act unconsciously due to his mental condition that somehow interfered with his mental capacity to make explicit judgments. Other common cases involve accidents that are caused by high blood alcohol concentration. In such as case, the health professionals will have to share the diagnostic results with the law enforcement officers to get justice for the victims and the casualties of the accidents. Other cases where the breach of the contract includes when the patient is a minor when the health practitioner has cause to believe that the disabled individual is being abused or exploited.
Acceptability of the Breach of confidentiality
The acceptability of the breaches of confidentiality has been an issue of contention. In the recent past, we have seen some health professionals getting sued over the issue of breach of privacy. This brings up the question of the acceptability of the violation of the confidentiality of the patient records. The adoption of the HIT (Health Information Technology) has been attributed to the success of the medical care as well as cutting the costs involved in health care programs. However, not everyone is pleased with how the system works since it allows all the health professionals in the healthcare fraternity to access a database of information relating to different patients.
Many patients do not accept the breaches of confidentiality that often happens in the medical practice. Patients who have HIV/AIDS being the biggest opponents of the confidentiality clause (Cristina M. Beltran-Aroca 15). These breaches have often led to the stigmatization of the patients by the society as well as the community as a whole, a fact that has made their lives miserable as they feel segregated by the people they feel they should be closest to.
Health practitioners on the other hand argue that, health care being a collaborative venture involves the sharing of information with practitioners from other disciplines so that they can be able to develop a program that will aid in the provision of quality medical care to the patients while reducing the costs involved in the provision of the health care. However, this is not entirely accurate as the breach often involves even non-professionals in the healthcare facilities, for instance, the spouses of the health practitioners.
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In conclusion, the breach of confidentiality in the health care practices is still a matter of contention. The providers of the health services often feel that sharing information is key to the multidisciplinary approach to health care services and that’s why they adopted the use of Health Information Technology to facilitate the free flow of information among the health practitioners. Patients on the other hand totally disagree with the disclosure of their information as it subjects most of them to the judgment by the society as well as their families.
- Courtney Mathews, Andreia Martins Martinho. “Patient-Physician Confidentiality: ’Til Death Do Us Part?” American Medical Association Journal of Ethics (2012): 720-723. Print.
- Cristina M. Beltran-Aroca, Eloy Girela-Lopez, Eliseo Collazo-Chao, Manuel Montero-Pérez-Barquero, Maria C. Muñoz-Villanueva. “Confidentiality breaches in clinical practice: what happens in hospitals?” BMC medical ethics (2016): 1-14. Print.
- Allmark, Peter. “HIV and the boundaries of confidentiality.” Journal of advanced nursing 21.1 (1995): 158-163. Print.
- Benn, Christoph, and Kenneth Boyd. “Ethics, medical ethics and HIV/AIDS.” The Ecumenical Review 48.2 (1996): 222-232. Print.