Medical secrecy: the rights and responsibilities of participants of the medical process
Background. Medical secrecy (MS) is a set of information about the disease, its treatment, the results of examinations, which became known to certain healthcare workers (HCW) during their professional activities. The attending physician and the nurse who performs the drug administration are most aware of the patient’s condition. The information included in the MS is divided into two types: medical and personal information of the patient, which became known during the performance of medical professional duties.
Objective. To describe selected aspects of the MS problem.
Materials and methods. Analysis of the legal framework.
Results and discussion. Medical information belongs to professional confidential information and should not be disclosed. Even the information about the very fact of seeking medical care belongs to professional confidential information. Unlawful intentional disclosure of MS by a person to whom it became known in the course of its professional duties entails criminal liability. This applies not only to HCW, but also to other staff of medical institutions. It is possible to provide information about the treatment and even the patient’s stay in the hospital to third parties, including relatives of any degree of kinship, only with the patient’s own consent. Exceptions include cases of extreme urgency, such as when a patient is taken to hospital unconscious and relatives can provide information on existing allergies and comorbidities. Of course, in such cases, the necessary disclosure limits should be followed. If a relative or other person wishes to visit a patient in the hospital, he or she should be contacted in person and visited only with personal consent. With regard to law enforcement officers, the answer to the question of whether a particular patient is treated in this institution should be given only in the presence of criminal proceedings and after resolving this issue with the chief physician. It should be noted that medical information concerning the deceased is also confidential and cannot be disclosed. It should not be assumed that the deceased can no longer be harmed, so any liability will be absent. Disclosure of such information is also a crime, on the basis of which criminal proceedings may be started. Recently, the medical legislation in Ukraine was changed, and as of today, the fine for disclosing MT is over UAH 50,000. When treating patients with disabilities, all necessary information should be provided to their parents or carers. When treating children aged 14-18, it is impossible not to provide information about treatment to parents, although this may be contrary to the wishes of the child. An important issue is the provision of information to children who are incapacitated by age, but legally capable. If a 5-year-old child asks questions about his or her health, a doctor or other HCW must answer them in a form that is accessible. A similar situation occurs with mentally ill patients: they are deprived of legal capacity, but they have the right to know about their health. You should also be very careful in keeping medical records. For example, information on viral infections (hepatitis, HIV/AIDS) should not be placed on the cover of the medical history, but inside.
Conclusions. 1. MS information is divided into two types: medical and personal information of the patient. 2. Medical information belongs to professional confidential information and should not be disclosed. 3. It is possible to provide information about the treatment and even the patient’s stay in the hospital to third parties, including relatives, only with the patient’s own consent. 4. In the treatment of patients with disabilities, all necessary information should be provided to the parents or carers.
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