Confidentiality in Medicine

1
Confidentiality in Medicine A Decrepit
Concept Mark Siegler
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MEDICAL CONFIDENTIALITY

• Mark Siegler thinks that medical confidentiality,
  as typically understood, no longer exists. (To
  say that it is decrepit means that it is
  worn-out, and so no longer able to function as it
  once did.)
• He does not think that it can preserved, nor does
  he think that it should be.
• This is because, in his view, it results in more
  problems than solutions.

3
CONFIDENTIALITY AND THIRD-PARTY INTERESTS

• Third-party interests are interests that people
  other than the patient and physician have.
• Siegler says that there can be a problem between
  patient confidentiality and third-party interests
  when third-party interests would be threatened
  were the physician not to release medical
  information about the patient.

4
CONFIDENTIALITY AND THE PATIENTS INTERESTS I

• Siegler thinks that a patients interest in
  maintaining his or her confidentiality might
  conflict with the patients receiving the best
  health care possible.
• This is because many different doctors and
  healthcare professionals may be involved in
  providing the best healthcare possible for the
  patient - as when the patient is in a hospital.
• In such a case, confining the patients
  information to his or her primary physician would
  not be in the best interest of the patient.

5
CONFIDENTIALITY AND THE PATIENTS INTERESTS II

• Siegler says the relation of third-party payment
  for a patients medical care might affect the
  patients confidentiality.
• Because of the expense of health care, the
  patient is not likely to be paying for his or her
  care alone. Rather, an insurance company will
  likely be involved.
• And so many people who work for the company will
  need to have access to the patients records in
  order to ensure payment.

6
CHANGE IN MEDICINE

• According to Siegler, medicine has expanded from
  from a narrow model based on the patients
  disease to a wider model that includes
  psychological, social, and economic problems.
• This change - together with healthcare teams
  replacing individual physicians and the
  expanding limits of medicine - makes us think
  differently about medical confidentiality from
  the way that we have in the past.

7
THE IMPORTANCE OF CONFIDENTIALITY

• Siegler points out that confidentiality serves
  two important purposes in medicine.
• First, it respects the patients individuality
  and privacy. These are important to protect the
  patient from shame and vulnerability.
• Second, it is important in improving the
  patients healthcare.
• He does not think that the importance of these
  two things will change or be replaced as medicine
  improves and otherwise changes.

8
HONESTY AND TRUST

• For Siegler, it is vitally important for a
  patient to feel that she can talk honestly to her
  physician and that she can trust her physician.
• Honesty and trust in medicine are vitally
  important in assisting the doctor in diagnosing
  and treating a patients condition.
• And so, again, confidentiality is of key
  significance in improving the patients health
  care.

9
DIFFERENT MEDICAL SETTINGS

• Siegler says that patient confidentiality differs
  whether or not we are talking about treating the
  patient in a doctors office or a larger
  institutional setting, such as a clinic or a
  hospital.
• However, in a larger institutional setting, a
  patients records can still be confined to those
  who need to see them in order to help the
  patient.
• Confidentiality is confined then to people who
  need to have access to patient records in the
  interest of patient benefit.

10
INFORMING PATIENTS ABOUT CONFIDENTIALITY

• Siegler thinks that patients should be informed
  about what is meant by patient confidentiality
  
• And they should be made to understand the
  distinction between information that will be kept
  confidential regardless of third-party interests,
  and information that will be shared by healthcare
  providers for the purpose of providing the best
  care possible for the patient.

11
PATIENT RECORDS

• Siegler thinks that most patients should at some
  point be able to review their own medical
  records.
• This is so that they can make informed choices
  about what information should be kept solely
  between doctor and patient, and what information
  should be shared for the purpose of providing the
  best healthcare possible.
• This would rely on traditional standards and
  procedures of informed consent.