NEWS
CONFIDENTIALITY
IN YOUR MEDICAL PRACTICE
Confidentiality in the medical field is not only an ethical issue, it is a legal obligation and is fundamental to
the trust between healthcare practitioners and patients.
Healthcare practitioners are held
responsible by their professional
bodies for protecting personal
information that patients share
with them but the obligation to
protect a patient’s confidential
information goes beyond simply
undertaking not to divulge
sensitive information to other
parties. Procedures should be
implemented to ensure the safety of
all confidential information to which
healthcare practitioners and staff
are exposed.
The National Health Act 61 of 2003
explains “personal information” as
any information about a person that
a healthcare practitioner learns in a
professional capacity and from which
that individual can be identified. This
information is usually obtained after a
consultation and/or examination or the
application of health management.
Patients have the right to expect
that this information will be held
in confidence by all healthcare
practitioners and providers.
It is important to note that a
health worker or any healthcare
provider that has access to the health
records of a patient may disclose
personal information to another
person, healthcare provider or health
establishment if the disclosure
is necessary within the ordinary
course and scope of the healthcare
practitioner’s duties or where such
access or disclosure is in the interests
of the patient.
South African law provides for the
protection of confidential information
with the following:
• There is a common-law duty on
healthcare practitioners to preserve
professional confidence. Common-law
is a branch of law developed by judges
and courts from cases that have a
precedential effect on future cases.
• The South African Constitution
guarantees the right to privacy which
includes the right not to have the
privacy of communications infringed.
• The Medical Protection Council’s
Ethical Guide states that healthcare
practitioners may only divulge
confidential information without
a patient’s consent in specific
circumstances.
• The National Health Act makes it an
offence to divulge information about
a patient, without a patient’s consent.
The only exceptions are when the law
or a court order requires disclosure,
or if non-disclosure would represent a
serious threat to public health.
• The HPCSA states that patients have
a right to expect that information
about them will be held in confidence
by healthcare practitioners. Without
assurances about confidentiality,
patients may be reluctant to give
practitioners the information needed
to provide good care.
Many disclosures of confidential
information in medical practices
are unintentional. If a healthcare
practitioner is asked to provide
confidential information about a patient,
it is important to:
1. Firstly, if possible, try to obtain the
Roxanne van Rugge
FDM Legal, professional trainer
and legal advisor
patient’s consent to disclose the
information. This is necessary even if
the patient isn’t likely to be identified
from the disclosure. Patients must
also be made aware of the potential
breach of confidentiality with ICD10
coding.
2. Secondly, where unidentifiable data
will serve the same purpose, data
should be anonymised.
3. Disclosures should be kept to a
minimum.
In order to promote ethical conduct
within the medical field, the making
and keeping of records is important but
protecting patient confidentiality is also
essential with the increase in litigation
against healthcare practitioners.
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