[Waiver of medical confidentiality].
The duty to maintain medical confidentiality is one of the fundamental and well-known obligations imposed on physicians, and is incorporated in the Law of Patient's Rights 1996 (the Law). Medical confidentiality applies to information conveyed to a physician for medical purposes trusting that the physician will not disclose it. The patient's identity and financial arrangements are not confidential. Any physician who breaches this duty may face civil, disciplinary or criminal lawsuits. The Law, as well as specific provisions in other rulings, defines the exceptions to the duty of upholding medical confidentiality. According to these provisions there are special circumstances in which a physician may, and even should, transfer medical data relating to his/her patients. One of these exclusions is the patient's consent to reveal the information. This article presents the legal infrastructure of medical confidentiality, and the means and circumstances in which medical confidentiality can be waived. Waiver of medical confidentiality does not constitute permission to convey all the information to one and all, and the Law determines that only the data required for specific purposes should be transferred. The way by which the patient waives his right for confidentiality is not defined by the Law or by regulations. A patient's consent to waive his right for confidentiality can be allegedly obtained in writing, orally or by behavior. It seems that the appropriate manner of waiving medical confidentiality is in writing. The waiver form should specify the nature and extent of information that can be conveyed, and it must be signed by the patient. The doctor is also responsible to ensure privacy during the transmission of the data. Specific subjects which are associated with the duty to maintain medical confidentiality are also discussed in this paper. In cases when a man's life or safety is at stake, the duty of a physician to protect life overweighs his duty to entrusted confidentiality. In such cases, the physician should transfer the information even if the patient did not waive his right for secrecy. This obligation also applies to patients who suffer from specific diseases, for example HIV. The duty to maintain medical confidentiality is relevant to the patient's relatives. Obtaining written consent to convey the information to family members is not practical. However, it is recommended that a physician should provide the information only to relatives he knows, and only when he can reasonably assume that the patient will agree.
Kaplan
Ofer
O
Department of Surgery A, Tel Aviv Medical Center, Tel Aviv, Israel. okaplan@post.tau.ac.il
D003219:Confidentiality / Q000331:legislation & jurisprudence*; D006801:Humans; D007557:Israel; D028701:Patient Rights / Q000331:legislation & jurisprudence*