It is an implied term of contract between the doctor and his patient. The doctor is obliged to keep secret; all that he comes to know concerning the patient in the course of his professional work. Everything said by a patient or his family members to a physician in the context of medical diagnosis and treatment is confidential.
Its disclosure would be a failure of trust and confidence. It assumes that without medical confidentiality, patients will not reveal everything during a consultation, esp. intimate details, due to which the clinical history may be deficient or even misleading.
The patient can sue the doctor for damages (mental suffering, shame or humiliation) if the disclosure is voluntary, has resulted in harm to the patient and is not in the interest of the public.
The following points may be noted in medical confidentiality
(1) A doctor should not discuss the illness of his patient with others without the consent of the patient.
(2) If the patient is major, the doctor should not disclose any facts about the illness without his consent to parents or relatives even though they may be paying the doctors fees thus maintaining medical confidentiality. In the case of a minor or an insane person, guardians or parents should be informed of the nature of the illness.
(3) A doctor should not answer any inquiry by third parties even when inquired by near relatives of the patient, either with regard to the nature of the illness or with regard to any subsequent effect of such illness on the patient without the consent of the patient.
(4) Even in the case of husband and wife, the facts relating to the nature of illness of the one, must not be disclosed to the other, without the consent of the concerned person.
(5) In divorce and nullity cases, no information should be given without getting the consent of the person concerned.
(6) A doctor should not disclose any information about the illness of his patient without the consent of the patient even when requested by a public or statutory body, except in case of notifiable diseases and thus maintain medical confidentiality. If the patient is a minor or insane, consent of the guardian should be taken.
(7) When a domestic servant is examined at the request of the master, the doctor should not disclose any facts about the illness to the master without the consent of the servant, even though the master is paying the fees.
(8) When a doctor examines a Government servant on behalf of the Government, he cannot disclose the nature of illness to the Government without the patient’s consent.
(9) The medical officer of a firm or factory should not disclose the result of his examination of an employee to the employers without the consent of the employee.
(10) Medical officers in Government service are also bound by the code of medical confidentiality, even when the patient is treated free.
(11) A person in police custody as an under trial prisoner has the right not to permit the doctor who has examined him, to disclose the nature of his illness to any person. If a person is convicted, he has no such right and the doctor can disclose the result to the authorities.
(12) The medical examination for taking out life insurance policy is a voluntary act by the examinee, and therefore consent to the disclosure of the finding may be taken as implied. A doctor should not give any information to an insurance company about a person who has consulted him before, without the patient’s consent and hence maintain medical confidentiality. Any information regarding a dead person may be given only after obtaining the consent from the nearest relative.
(13) In reporting a case in any medical journal, care should be taken that patient’s identity is not revealed from the case notes or photographs.
(14) In the examination of a dead body certain facts may be found, the disclosure of which may affect the reputation of the deceased or cause mental suffering to his relatives, and as such, the doctor should maintain medical confidentiality.