Confidentiality

Law and ethics state that the doctor-patient interaction should remain confidential. The physician should never reveal confidential information unless the patient wants this information disclosed to others, or unless required to do so by law. If the release of information is warranted, information should be released in the form of an official signed document.

• Confidentiality is subject to certain exceptions because of legal, ethical, and social considerations.
  • When patients are at risk of physically harming another person, or if those patients are at risk of harming themselves, the physician has the legal obligation to protect the potential victim and notify law enforcement authorities.

  • All US states and Canadian provinces require all cases of child abuse to be reported to the district attorney's office and/or child protective services. This includes suspected and confirmed cases of child abuse. Failure of health care personnel to report child abuse and neglect may result in criminal prosecution under the Child Abuse and Prevention Act of 1974. Failure to report child abuse may also result in civil prosecution for malpractice if the child suffers injury or death because the abuse was not reported. This is another special case in which patient confidentiality does not exist.

  • In addition to child abuse, confidentiality does not apply to cases involving communicable diseases, gunshot wounds, and knife wounds.

  • The subject of minors creates a special situation regarding confidentiality. The laws vary from state to state. Most states regard a person younger than 18 years as a minor.
    • An exception is made for emancipated minors, who are considered self-reliant because, for example, they are married or have children themselves. Emancipated minors are usually regarded as adults in reference to their medical care.

    • Minors who live with their parents but are self-reliant and independent are considered mature minors. In some states, a mature minor may be considered an adult regarding medical treatment. In various states and depending on the situation, minors can consent to treatment for contraception, drug and alcohol problems, psychiatric conditions, pregnancy, abortion, and venereal diseases without the knowledge of their parents.