Ethical issues/problems of the case

1. “What happened to dear PK, he is our idol? Why was a CT done? What was the result of the procedures?” • “Since the people who texted you were your friends, co-residents and co-healthcare workers in the hospital, you texted back what happened to PK “

2. Ethical issues/problems of the case • Medical professionals did not preserve the principle of confidentiality. This was exemplified when: • Other medical professionals (co-residents and co-healthcare) who are not part of the attending medical team inquired regarding the status and well-being of a private patient. • The attending radiologist disclosed private information by texting back

3. Physicians have a prima facie obligation to preserve confidentiality, but such prima facie duties can be overridden for weighty reasons and not just by mere curiosity • When confidentiality is breached, no matter what the weight of the argument, physicians are blameworthy… Textbook of Healthcare Ethics 2nd ed

4. Breaching a confidence and violating a trust are not now, nor can they ever be, “good” things • But they can, on the grounds of harm and benefit to others, be a better, and often far better, alternative than passively allowing great harm to occur Textbook of Healthcare Ethics 2nd ed

5. Medical professionholds confidentiality of the patient-physician relationship isrecognized in the current Code of Medical Ethics of the American MedicalAssociation: • In most states, either by statute or case law, disclosure ofmedical information is prohibited without consent of the patient. • Onestate court, after observing that the privacy right of patients warrants constitutional protection, ruled that patients mustbe able to secure medical services without fear of betrayaland unwarranted embarrassing and detrimental disclosure of private information. • The same court added that the obligation ofmedical confidentiality relative to patient records and informationapplies not only to physicians but to hospitals as well. Smith and Berlin, Malpractice Issues in Radiology; AJR 2001; 176:599-602

6. Radiologists should take reasonable care to keep statusconfidential, with access provided only to those health careprofessionals involved in the patient's care. • Reasonable carerequires, at a minimum, adherence to all applicable laws andinstitutional guidelines, as well as observance of commonsenseprecautions such as limiting medical record access in potentially sensitivecases. Smith and Berlin, Malpractice Issues in Radiology; AJR 2001; 176:599-602

7. The nature of confidentiality obligation is to ensure that the information is seen only by those who need to see it in the patient’s interest. • If others wish to have access to this information for other purposes, for instance for research, they may access and use it with patient’s consent, or at least receive it only in an anonymous form R E Ashcroft, MA, PhD & P R Goddard, MD, FRCR; Ethical Issues in Teleradiology; The British Journal of Radiology, 73 (2000), 578-582.

8. As physicians, radiologists have both a legal and an ethical responsibilityto respect patient confidentiality. • The radiologist’s relationship with a patient ranges from interpreting a radiograph, in which case there is usually no direct contact, to performing a diagnostic or interventional study, where one does have some degree of direct contact with the patient. The patient’s right to confidentiality is the same, no matter what the depth of the doctor-patient relationship. • Unauthorized disclosure to third partiesand discussion of a patient’s disease in public areas of the hospital are breaches of confidentialityagainst which all physicians must constantly be on guard. Patient Confidentiality in Radiology From: Douglas L. Brown, MD Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School 75 Francis Street, Boston, MA 02115

9. Section 6. The physician should hold as sacred and highly confidential whatever may be discovered or learned pertinent to the patienteven after death, except when required in the promotion of justice, safety and public health. CODE OF ETHICS OF THE PHILIPPINE MEDICAL ASSOCIATION