A talk delivered by Prof Faisal Ghani for 3rd year medical students at Alfarabi Medical College about the privacy of patients and how to maintain it.

1. Asst. Prof. of Medical Ethics
Dr. Ghaiath M. A. Hussein
Privacy of Patients in
Clinical Care
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2. OUTLINE
Definitions and differences
How to maintain the privacy of our
patients?
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3. Confidentiality :
- Is the right of an
to have personal,
identifiable medical
information kept out of
reach of others.
Privacy:
- A right or expectation to
not be interfered with
- Be free from surveillance
- A moral right to be left
alone.
RESPECTS PATIENT’S
BODY
RESPECTS PATIENT’S
INFORMATION
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4. PRIVACY
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5. PRIVACY - DETAILED
• Patient privacy encompasses a number of
aspects, including:
• Personal space (physical privacy),
• Personal data (informational privacy),
• Personal choices including cultural and religious
affiliations (decisional privacy), and
• Personal relationships with family members and other
intimates (associational privacy).
• AMA Code of Ethics
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6. ACP GUIDELINES
• The presence of a chaperone during a
physical examination may contribute to
patient and physician comfort
• Physicians should ask patients if they prefer
to have a chaperone present
• Physicians must remain cognizant of the
privacy settings for secure messaging and
recording of patient-physician interactions
as well as online networks and media and
• should maintain a professional behaviour in
accounts that could be viewed by patients or
the public
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7. PATIENT PRIVACY IN CLINICAL
ENCOUNTER
• When individuals who are not involved in providing
care seek to observe patient-physician encounters
(examples?), the following should be considered:
a) The patient has explicitly agreed to the presence of
the observer(s). Outside observers should not be
permitted when the patient lacks decision-making
capacity, except in rare circumstances and with the
consent of the parent, legal guardian, or
authorized decision maker.
b) The presence of the observer will not compromise
care.
c) The observer understands and has agreed to
adhere to standards of medical privacy and
confidentiality.
d) Under no circumstances should physicians accept
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8. RECORDING PATIENTS FOR EDUCATION IN
HEALTH CARE
(a) Ensure that all nonclinical personnel present during
recording understand and agree to adhere to
medical standards of privacy and confidentiality.
(b) Restrict participation to patients who have
decision-making capacity. Recording should not be
permitted when the patient lacks decision-making
capacity except in rare circumstances and with the
consent of the parent, legal guardian, or
authorized decision maker.
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9. RECORDING PATIENTS FOR EDUCATION IN
HEALTH CARE
c) Inform the patient (or authorized decision maker, in
the rare circumstances when recording is
authorized for minors or patients who lack
decision-making capacity):
(i) about the purpose of recording, the intended
audience(s), and the expected distribution;
(ii) about the potential benefits and harms (such as
breach of privacy or confidentiality) of participating;
(iii) that participation is voluntary and that a decision
not to participate (or to withdraw) will not affect the
patient’s care;
(iv) that the patient may withdraw consent at any time
and if so, what will be done with the recording; 9

10. MEASURES TO PROTECT
PRIVACY (KSA GUIDELINES)
1. Make sure examination takes place in isolation from
other patients, unauthorized family members, and/or
staff
2. Provide gender-sensitive waiting and examination rooms
3. Provide proper clothing for the admitted patients
4. Make sure patients are well covered when transferred
from one place to another in the hospital
5. Make sure your patient’s body is exposed ONLY as much
as needed by the examination or investigation
6. Patients should have separate lifts and be given priority
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11. MEASURES TO PROTECT
PRIVACY
7. Make sure there is another person (chaperone, nurse) of
the same sex as the patient present all the time of the
examination
8. Always take permission from the patient before
examination
9. Insure privacy when taking information from patients
10. Avoid keeping patients for periods more than required by
the procedure.
11. It’s prohibited to examine the patient in the corridors or in
the waiting area.
12. During examination, no foreign person unrelated to the
patient allowed
13. Give patients enough time to expose the part with pain
14. Only relevant personnel are allowed to enter the
examination room 11

12. ‫إسالمية‬ ‫توجيهات‬(‫الطبي‬ ‫العالج‬ ‫ألجل‬ ‫العورة‬ ‫كشف‬ ‫حكم‬)
•‫تعالى‬ ‫قال‬( :ِ‫ار‬َ‫ص‬ْ‫ب‬َ‫أ‬ ْ‫ن‬ِ‫م‬ ‫وا‬ُّ‫ض‬ُ‫غ‬َ‫ي‬ َ‫ين‬ِ‫ن‬ِ‫م‬ْ‫ؤ‬ُ‫م‬ْ‫ل‬ِ‫ل‬ ْ‫ل‬ُ‫ق‬َ‫أ‬ َ‫ك‬ِ‫ل‬َ‫ذ‬ ْ‫م‬ُ‫ه‬َ‫ج‬‫و‬ُ‫ر‬ُ‫ف‬ ‫وا‬ُ‫ظ‬َ‫ف‬ْ‫ح‬َ‫ي‬ َ‫و‬ ْ‫م‬ِ‫ه‬ْ‫م‬ُ‫ه‬َ‫ل‬ ‫ى‬َ‫ك‬ ْ‫ز‬
َ‫ون‬ُ‫ع‬َ‫ن‬ْ‫ص‬َ‫ي‬ ‫ا‬َ‫م‬ِ‫ب‬ ٌ‫ير‬ِ‫ب‬َ‫خ‬ َ َّ‫اَّلل‬ َّ‫ن‬ِ‫إ‬(30)ِ‫م‬ َ‫ْن‬‫ض‬ُ‫ض‬ْ‫غ‬َ‫ي‬ ِ‫ت‬‫َا‬‫ن‬ِ‫م‬ْ‫ؤ‬ُ‫م‬ْ‫ل‬ِ‫ل‬ ْ‫ل‬ُ‫ق‬ َ‫و‬َّ‫ن‬ِ‫ه‬ ِ‫ار‬َ‫ص‬ْ‫ب‬َ‫أ‬ ْ‫ن‬( ...31))
(‫النور‬ ‫سورة‬. )
•، ‫المريض‬ ‫معالجة‬ ‫ألجل‬ ‫يلمسها‬ ‫أن‬ ‫وكذلك‬ ‫العورة‬ ‫إلى‬ ‫الطبيب‬ ‫ينظر‬ ‫أن‬ ‫يجوز‬‫ولكن‬
‫بشروط‬:
.1‫الحاجة‬ ‫وجود‬ ‫أو‬ ، ‫المحظورات‬ ‫تبيح‬ ‫الضرورات‬ ‫ألن‬ ‫؛‬ ‫الضرورة‬ ‫وجود‬‫الملجئة‬
‫الضرورة‬ ‫منزلة‬ ‫تنزل‬ ‫التي‬.
.2‫بقدرها‬ ‫تقدر‬ ‫الضرورة‬ ‫ألن‬ ‫؛‬ ‫الضرورة‬ ‫بقدر‬ ‫العورة‬ ‫عن‬ ‫الكشف‬ ‫يكون‬.
.3، ‫المسلمة‬ ‫المرأة‬ ‫أمام‬ ‫المرأة‬ ‫وتكشف‬ ، ‫الرجل‬ ‫أمام‬ ‫عورته‬ ‫الرجل‬ ‫يكشف‬ ‫أن‬
.4‫نظر‬ ‫ألن‬ ‫؛‬ ‫الرجل‬ ‫على‬ ‫الكافرة‬ ‫المرأة‬ ‫تقدم‬ ‫المسلمة‬ ‫المرأة‬ ‫وجود‬ ‫عدم‬ ‫حالة‬ ‫في‬
‫أخف‬ ‫بعضه‬ ‫إلى‬ ‫الواحد‬ ‫الجنس‬.
.5‫ا‬ ‫على‬ ‫المسلم‬ ‫الطبيب‬ ‫م‬َّ‫د‬‫ق‬ُ‫ي‬ ‫والكافرة‬ ‫المسلمة‬ ‫المرأة‬ ‫وجود‬ ‫عدم‬ ‫حالة‬ ‫في‬‫لطبيب‬
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13. ‫إسالمية‬ ‫توجيهات‬(‫الطبي‬ ‫العالج‬ ‫ألجل‬ ‫العورة‬ ‫كشف‬ ‫حكم‬)
.6:‫الطبيب‬ ‫أمام‬ ‫العورة‬ ‫كشف‬ ‫يجوز‬ ‫المسلم‬ ‫الطبيب‬ ‫وجود‬ ‫عدم‬ ‫حالة‬ ‫في‬
‫الكافر‬
.7‫ف‬ ‫ينفع‬ ‫وما‬ ، ‫اللمس‬ ‫فيه‬ ‫يجوز‬ ‫فال‬ ‫اللمس‬ ‫دون‬ ‫النظر‬ ‫فيه‬ ‫ينفع‬ ‫ما‬‫اللمس‬ ‫يه‬
‫النظر‬ ‫فيه‬ ‫يجوز‬ ‫فال‬ ‫النظر‬ ‫دون‬
.8‫حائل‬ ‫دون‬ ‫يجوز‬ ‫فال‬ ‫بحائل‬ ‫اللمس‬ ‫فيه‬ ‫ينفع‬ ‫ما‬.
.9‫بالرجل‬ ‫الطبيبة‬ ‫وال‬ ‫بالمرأة‬ ‫الطبيب‬ ‫يخلو‬ ‫ال‬
.10‫م‬َّ‫محر‬ ‫وغير‬ ‫مشروع‬ ‫عالج‬ ‫ألجل‬ ‫الطبيب‬ ‫أمام‬ ‫العورة‬ ‫كشف‬ ‫يكون‬ ‫أن‬
.11‫به‬ ‫للمريض‬ ‫حاجة‬ ‫ال‬ ‫من‬ ‫الطبيب‬ ‫مع‬ ‫يشترك‬ ‫ال‬ ‫أن‬.
.12‫م‬َّ‫المحر‬ ‫يبيح‬ ‫ال‬ ‫المريض‬ ‫رضى‬
.13‫نفسه‬ ‫المريض‬ ‫يهيئ‬–‫أمكن‬ ‫إن‬-‫يدخل‬ ‫وبعدها‬ ، ‫الطبيب‬ ‫وجود‬ ‫دون‬
‫االستئذان‬ ‫بعد‬ ‫الطبيب‬
.14‫المرض‬ ‫لقوة‬ ً‫ا‬‫ومناسب‬ ً‫ا‬‫مالئم‬ ‫العورة‬ ‫من‬ ‫المكشوف‬ ‫يكون‬ ‫أن‬.
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14. REFERENCES
• AMA Principles of Medical Ethics: https://www.ama-
assn.org/sites/default/files/media-browser/code-of-medical-ethics-chapter-
3.pdf
• ACP Ethics Manual Sixth Edition: https://www.acponline.org/clinical-
information/ethics-and-professionalism/acp-ethics-manual-sixth-edition/acp-
ethics-manual-sixth-edition
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