Patient / Doctor Confidentiality

gozunda

Is there a basis in law for Patient / Doctor confidentiality?

If this is breached is there any recourse for remedy?

Thoie

There are times when a doctor is obliged to break patient confidentiality (see section C here: http://www.medicalcouncil.ie/Public-Information/Professional-Conduct-Ethics/The-Guide-to-Professional-Conduct-and-Ethics-for-Registered-Medical-Practitioners.pdf)

If you feel confidentiality has been breached outside those areas, you can complain to the Medical Council. http://www.medicalcouncil.ie/Public-Information/Making-a-Complaint-/

Reloc8

Yes and yes.

In the general sense, if you feel your doctor has violated your confidentiality unlawfully (it is not absolute) you would complain to the medical council.

drkpower

Reloc8 wrote: »

Yes and yes.

In the general sense, if you feel your doctor has violated your confidentiality unlawfully (it is not absolute) you would complain to the medical council.

Theoretically, you could also seek damages for breach of confidence although i dont think there have been any successful (or even unsuccessful) cases in ireland.

gozunda

Ok in a non specific scenario a doctor gives information on the patients treatment / condition in relation to a court case as part of their evidence

Where does the patients right to confidentially sit in relation to this? Does the giving of evidence negate or impose on such confidentiality

drkpower

Who are the parties to the court case?
What is the relevance of the patient's medical information to the court case?

Ken.

Confidentiality and disclosure

Doctors and other medical personnel and health institutions have a duty to maintain patients' records in confidence but there are some circumstances in which they may be obliged to give this information to third parties.
Their ethical duty with regard to confidentiality is set out in the Medical Council guidelines Guide to Ethical Conduct and Behaviour (pdf)
There are some circumstances in which a health professional (or hospital) may disclose confidential medical records to others - for example, if the patient consents to such disclosure or when it is required by a court. It seems that it may also be ethical to disclose medical records if it would be in the patient's best interests or, if necessary, to protect another person or society generally. There are certain legal requirements to disclose information, for example, in relation to infectious diseases. Doctors are obliged to report incidences of specified infectious diseases to the Health Service Executive (HSE) and the Health Protection Surveillance Centre.
The confidentiality of personal information such as medical records is protected by both the Data Protection Acts and the Freedom of Information Acts. Under these Acts, third parties may not get access to personal information except under exceptional circumstances. These third parties would be parents/guardians and personal representatives.




Court cases
Discovery

Patients and others may access medical records for the purpose of court cases if they get a court order of "discovery". The court may order a hospital or doctor to disclose or "discover" documents or medical records to a plaintiff's advisers where those documents are considered relevant to the issues involved in the court proceedings.
Where to apply

Taken from
http://www.citizensinformation.ie/en/health/legal_matters_and_health/access_to_medical_records.html

Victor

gozunda wrote: »

Ok in a non specific scenario a doctor gives information on the patients treatment / condition in relation to a court case as part of their evidence

Where does the patients right to confidentially sit in relation to this? Does the giving of evidence negate or impose on such confidentiality

In such a case, the patient would likely have given the doctor permission to release the information.

I'm not sure what the situation is regarding a third party doctor, e.g. a police doctor as a witness for the prosecution in a criminal case or as a witness for the insurer in an insurance case.

drkpower

Victor wrote: »

I'm not sure what the situation is regarding a third party doctor, e.g. a police doctor as a witness for the prosecution in a criminal case or as a witness for the insurer in an insurance case.

If we are talking about a plaintiff's medical records, they waive their right to confidentiality by commencing proceedings and they are also obliged to consent to a medical examination, to provide access to their relevant medical records and to allow permission to the defence to interview their treating doctors. So effectively, when suing someone for personal injuries, you have very little medical confidentiality left.

gozunda

drkpower wrote: »

If we are talking about a plaintiff's medical records, they waive their right to confidentiality by commencing proceedings and they are also obliged to consent to a medical examination, to provide access to their relevant medical records and to allow permission to the defence to interview their treating doctors. So effectively, when suing someone for personal injuries, you have very little medical confidentiality left.

Says who / Where?
Medical examination - even where that is not possible?
References would be useful to back up such statements

See below

ken wrote: »

Confidentiality and disclosure
...
Court cases
Discovery

Patients and others may access medical records for the purpose of court cases if they get a court order of "discovery". The court may order a hospital or doctor to disclose or "discover" documents or medical records to a plaintiff's advisers where those documents are considered relevant to the issues involved in the court proceedings.
Where to apply

Taken from
http://www.citizensinformation.ie/en/health/legal_matters_and_health/access_to_medical_records.html

Reloc8

gozunda wrote: »

Says who / Where?
References would be useful to back up such statements

Are you disputing that the answer given was correct ?

gozunda

Reloc8 wrote: »

Are you disputing that the answer given was correct ?

Meh?

Ken above posted referenced information that appears to somwhat contradicts this statement ref confidetianily & discovery

So looking to see is this posters own opinion or have they actually this from a referenced source

Tbh I don't get your question ? Do you have an opinion on the non referenced source that could shed some light perhaps!

drkpower

gozunda wrote: »

Says who / Where?
Medical examination - even where that is not possible?
References would be useful to back up such statements

A little gratitude would be useful when getting free advice!

The position was addressed in the Supreme Court decision in McGrory –v- ESB [2003] 3 IR 407 from which the following principles can be drawn:
1. The Plaintiff who sues for damages for personal injuries, by implication necessarily waives the right of privacy that he/she would otherwise enjoy in relation to his/her medical condition.
2. The Defendant can seek sight of the relevant medical records prior to the pleadings being closed, regardless of their right to obtain same on discovery subsequently.
3. The court can stay proceedings where the Plaintiff refuses to submit to medical examination or disclose medical records to the Defendant or permit
the Defendant to interview his/her treating doctor.
4. The judgment does not alter the position that medical reports that are covered by privilege may not be disclosed to the other side.
5. The judgement also does not absolve the solicitor of responsibility to obtain his client’s consent to furnish medical records to the Defendant’s solicitor.
6. Only medical records relevant to the claim should be furnished and this requirement should be read in conjunction with the provisions of S.I.
311/1999 relating to discovery, setting out the essential criteria of necessity and relevance

http://www.lawsociety.ie/documents/Committees/litigation/medicolegal08.pdf

gozunda

drkpower wrote: »

A little gratitude would be useful when getting free advice!

This is a free forum - I didn't know you could charge? infact the forum doesn't allow advice free or otherwise afaik!

Gratitude eh? Now that's rum/

I believe was some small contradiction between Kens and that answers tbh

Ken gave a good reference to back it up...
Thanks Ken

But You had not referenced your own information- hence obvious question.

But thanks for the link - the caveats are interesting....

drkpower

gozunda wrote: »

I believe was an some small contradiction between Kens and that answers tbh

There is no contradiction between the information provided by ken and that provided by myself.

gozunda

drkpower wrote: »

There is no contradiction between the information provided by ken and that provided by myself.

Hmmmm...

Tcsh - see the correct use of the conditional tense in Kens reply. And One had a reference the other did not ...

Thanks anyway

drkpower

gozunda wrote: »

Tcsh - see the use of the conditional tense in Kens reply. And One had a reference the other did not ...

That doesn't make them contradictory.

gozunda

drkpower wrote: »

That doesn't make them contradictory.

Without reference 'twas not possible to determine if that was opinion or fact

The use of the conditional in terms of confidentiality makes quite a difference imo

But as I said thanks...

drkpower

gozunda wrote: »

Without reference 'twas not possible to determine if that was opinion or fact.

That still doesn't make them contradictory. What Ken posted was accurate; as was what I posted. Where did you see a contradiction?

drkpower

gozunda wrote: »

The use of the conditional in terms of confidentiality makes quite a difference imo.

In what way?

Reloc8

gozunda wrote: »

Do you have an opinion on the non referenced source that could shed some light perhaps!

Yes.

But it's confidential.

gozunda

Reloc8 wrote: »

Yes.

But it's confidential.

Right so

MagicSean

I would have thought you'd had your fill of arguments in the abortion thread. Instead you come pick pointless ones here.

Common sense would dictate that you can't bring any kind of case involving injury without giving the other side access to the medical records concerning the injury. Common sense would also dictate that when the medical records are required for an investigation in the public interest, for example a murder, then there would be a power to obtain those records.

gozunda

Thanks to posters for the informative replies - they have clarified things in regard to the original query. Cheers