Medical confidentiality is a fundamental principle of medical ethics that requires doctors to keep a patient's identifiable information private without their consent unless there is an overriding public interest. Confidentiality builds trust between doctors and patients which is necessary for effective treatment. While confidentiality is important, it is not absolute and identifiable patient information may be disclosed under certain specific circumstances such as to protect others from serious harm.

1. MEDICAL PRIVACYA ND
CONFIDENTIALITY
(
‫التوفيق‬ ‫هللا‬ ‫نسأل‬ ‫للجميع‬ ‫هدية‬ ‫المحاضرات‬ ‫هذه‬
)
Dr EZIZ ALFAHD
afkaabba@gmail.com

2. What is the difference
between Privacy and
Confidentiality?
Privacy is about people.
Confidentiality is about data.

3. Privacy vs. Confidentiality
Privacy
 About people
 Sense of being in
control of access
that others have to
ourselves
 A Right to be
Protected
 Respect patient
Body
Confidentiality
 Extension of privacy
 About identifiable data
 an Agreement about
maintenance and who
has access to
identifiable data
 HIPAA - protects patients
from inappropriate
disclosures of “Respect and
Protected Health
Information" (PHI)

4. Definitions
 Privacy –
 about people and our sense of being in
control of others access to ourselves or to
information about ourselves with others.
 Confidentiality –
 treatment of identifiable, private
information that has been disclosed to
others.

5. Medical Confidentiality
 Respect for confidentiality is firmly
established in codes of medical ethics
Hippocratic oath
“whatever in connection with my professional
practice, or not in connection with it, I see or
hear in the life of men,which ought not to
be spoken of abroad, I will not divulge as
reckoning that all such should be kept
secret”

6. Medical confidentiality
 International Code of Ethics
“Except when obligated by the law of the
country concerned, a doctor shall not
disclose, without the consent of the patient,
information which he has obtained in the
course of his professional relationship with
the patient”

7. ‫الشرعي‬ ‫الواجب‬
‫األمانة‬ ‫مقتضى‬ ‫أنها‬
”
‫راعون‬ ‫وعهدهم‬ ‫ألماناتهم‬ ‫هم‬ ‫والذين‬
“
‫األسرار‬ ‫حفظ‬ ‫وجوب‬
”
‫أمانة‬ ‫فهي‬ ‫التفت‬ ‫ثم‬ ‫بالحديث‬ ‫الرجل‬ ‫حدث‬ ‫إذا‬
“
”
‫الترمذي‬
“

8. The Prophet
 (peace be upon Him)
described the three signs of the hypocrite
as:
"He lies when he speaks,
he breaks his promise and
he betrays when confided in “

10. Medical confidentiality - definitions
foundation of trust in Doctor-
patient relationship
a person puts trust and
confidence in another to act in
good faith for his best interest
fiduciary relationship

11. Medical confidentiality - definitions
 Keep private information secret or
undisclosed
 children, elderly, mentally disabled
and the dead all have the same right
to confidentiality

12. -Legal-Law ‫النظامية‬ ‫الناحية‬
‫والقانونية‬

13. ‫الثقة‬ ‫تعزيز‬ - Trust

14. Medical file

15. Medical confidentiality
-why is it important
 natural human desire for privacy
 fear of discrimination, stigmatization
 Information misused against patient
 preventing harm to others

16. Medical confidentiality
-why is it important
 builds confidence and open
communication
 demonstrates doctor’s fidelity to the
patient
 respects patient’s privacy, dignity and
individuality

17. Medical confidentiality
-importance
 Medical confidentiality respects patient
autonomy
 right to determine with whom, when
and how much of personal medical
information is shared

18. Keeping other persons' secrets is decreed on all the
Faithful ... the more so if these were Doctors, for
people willfully disclose their secrets and feelings to
their doctors, confident of the time old heritage of
Professional Secrecy, that the medical profession
embraced since the da wn of history. The Prophet
(peace be upon Him) described the three signs of the
hypocrite as: "He lies when he speaks, he breaks his
promise and he betrays when confided in".
Islamic Code of Medical Ethics

20. Medical confidentiality
-principles of disclosure
 Medical privacy and confidentiality is
not absolute to be not disclose
 Disclosure to -
 to proper authorities- need to know
 not beyond what is required or relevant
 reason for disclosure documented in the
medical records
you should inform patient that such
disclosure is required

21. -when ‫األسرار‬ ‫تفشى‬ ‫متى‬
‫؟‬
- Patients care ‫المريض‬ ‫رعاية‬ ‫غرض‬
Teaching purpose ‫التعليم‬ ‫لغرض‬
- Medical Research ‫العلمي‬ ‫البحث‬ ‫لغرض‬
Medical Fitness ‫الطبية‬ ‫اللياقة‬
For patients Family ‫العائلة‬ ‫ألفراد‬

22. -
‫لمن‬
‫األسرار‬ ‫تفشى‬
‫؟‬
- To
Whom - Medical team ‫الصحي‬ ‫الفريق‬
To the court ‫القاضي‬
- Police if needed ‫طة‬ ‫الشر‬
- Patient Family ‫العائلة‬ ‫أفراد‬
- Medical Admin ‫المستشفى‬ ‫ادارة‬

23. Medical confidentiality
- disclosure only because of following
issues :
 with patient’s consent and for benefit of
patient
 prevent harm to others
 when required by Law
 For Educational purposes
 medical research ,audit, registries
 sexual history & STD
 alcohol & drug dependence
 psychiatric conditions

24. Medical confidentiality
- disclosure for patient’s benefit
 In times of emergency
 Patient is incompetent
 Implied consent when care is shared
among professionals - only necessary
information for effective care of patient
 For the benefit of patients care
 To prevent harm to patient - epilepsy,
child abuse

25. Medical confidentiality
-disclosure to prevent harm to
others
 When harm to others outweighs his
duty to the patient
 seriousness of harm vs likelihood of
occurrence of harm
 to whom to tell; how to tell
 disciplinary action against doctor

26. Medical confidentiality
-disclosure required by Law
 Order of court - medical
litigation,coroner’s court, criminal
cases, compensation
 Drug abuse in Singapore
 Public health risk - Infectious Diseases
Act
 Factories (Medical Examinations)
Regulations 1985
 Enlistment Act for national service

27. Medical confidentiality
- medical certificates
 Medical certificates for claiming
benefits
 Patient’s and NOT doctor’s
responsibility to pass the information
 Doctor hands the info to the patient -
marked Private & Confidential
 Correct diagnosis written after
informing patient the possible
implications

28. Medical confidentiality
-disclosure for medical audit,
research,registeries
 approved by ethics committee
 ensure no harm to patient
 delink patient’s identifiable data
 registries operated under principle of
medical confidentiality
 where feasible get consent or inform
patient

31. Medical Confidentiality
-conclusions
 All medical information that doctors
acquire as part of the professional
practice is subject to the Duty of
Confidentiality
 Confidentiality is not absolute
 Disclosure should only occur with
consent, for benefit of patient or
with just grounds for disclosure

32. ‫الخالصة‬
‫ومعاقبة‬ ‫تحقيق‬ ‫مهنة‬ ‫ال‬ ‫وأمانة‬ ‫ستر‬ ‫مهنة‬ ‫الطب‬ ‫مهنة‬
.
‫إال‬ ‫فيها‬ ‫التصرف‬ ‫لغيره‬ ‫اليجوز‬ ‫له‬ ‫ملك‬ ‫المريض‬ ‫أسرار‬
‫الراجحة‬ ‫المصلحة‬ ‫وفق‬
.
‫والعيوب‬ ‫العورات‬ ‫ستر‬ ‫األصل‬
.
‫ودرء‬ ‫المصلحة‬ ‫تحقيق‬ ‫مع‬ ‫يدور‬ ‫وكشفه‬ ‫أ‬ ‫بالسر‬ ‫اإلحتفاظ‬
‫المفسدة‬
.
‫والتوجيه‬ ‫النصح‬ ‫واجب‬ ‫يلغي‬ ‫ال‬ ‫المريض‬ ‫على‬ ‫الستر‬ ‫أن‬
.
‫اآلخرين‬ ‫وحقوق‬ ‫المريض‬ ‫حق‬ ‫مراعاة‬ ‫ضرورة‬
.