Each patient, in the course of diagnosing, treating and preventing the development of diseases, provides the doctor with some personal information that is considered confidential data. The definition of “medical confidentiality” implies non-disclosure by a medical worker of information obtained as a result of communication with a person who came for help.
- Patient's secret
- When is disclosure of medical confidentiality without the patient’s consent allowed?
- Disclosure of medical confidentiality without the patient’s consent: responsibility
- Disclosure of medical confidentiality without patient consent: article
- Patient's medical confidentiality
This material will examine the legal aspects of the term, as well as cases when disclosure of medical confidentiality takes place.
What is medical confidentiality
In principle, everything is clear from the name. This is some information that doctors should not disclose. However, this applies not only to doctors, but also to other hospital personnel, as well as anyone who learned this information while performing their official duties.
Secret data includes Federal Law dated November 21, 2011 N 323-FZ:
- Diagnosis and health status of the patient.
- The very fact of going to a medical institution.
- Other information obtained during examination and treatment.
This information can only be shared with anyone with the written consent of the patient. If he is incapacitated or under 15 years of age, the document is signed by his legal representatives. From the age of 15, a child can make decisions related to his health. Federal Law of November 21, 2011 N 323-FZ. Therefore, telling parents anything without their consent is not allowed.
Patient health data cannot be used for teaching or scientific publications without the patient's permission. Moreover, they are prohibited from being disclosed even after his death.
That is, a clinic nurse should not, for example, call a friend and report that she saw her boyfriend standing outside the venereologist’s office. Perhaps from a moral point of view this seems logical. But the law here is higher than morality. Situations that seem quite harmless at first glance will also be considered violations. For example, when a grandmother calls a doctor to find out about her grandson’s health status, and he tells her everything. Unless parents have signed written consent, this is prohibited.
All these familiar (but terrible) things, when a doctor examines a patient in the presence of a stranger, discusses the diagnosis of a previous visitor with a nurse, and tells the class teacher about the illnesses of schoolchildren after a medical examination - this is a violation of the law.
Written consent for data availability
To obtain public access to patient data, doctors must have the patient's permission. And in writing. To do this, the document must include:
- Full name, address, identification document number, information about who and when it was issued.
- Full name and address of the citizen who received consent to access personal data.
- The purpose for which medical confidentiality is revealed.
- A list of exactly what personal information is accessible (diagnosis, treatment, etc.).
- A list of actions that a citizen who has received permission can subsequently perform.
- The specified period during which the permit is valid and the procedure for revocation.
At the same time, a citizen who has gained access to personal data cannot distribute it further unless there is additional written permission. In this case, he is obliged to keep the information received and maintain medical confidentiality. Access can be provided either partially to some data or completely to all information.
When can medical confidentiality be disclosed?
We sorted out the written consent from the patient himself. But there are cases when information can be shared without permission:
- If emergency medical intervention is required and the person's condition does not allow him to give consent.
- If there is a risk of the spread of infectious diseases, mass poisonings and injuries.
- At the request of law enforcement agencies.
- If a person is required to undergo drug treatment as an administrative penalty. Data is needed to monitor execution.
- If the minor is drug addicted. He is allowed to tell his parents that he has been sent for a medical examination or has received drug treatment.
- If there is a suspicion that the patient has become a victim of a crime. The doctor can share the information with law enforcement agencies.
- If a medical examination is carried out at the request of military commissariats and other institutions related to military and equivalent service.
- When investigating an accident at work or the occurrence of an occupational disease.
- When exchanging data between medical institutions.
- During checks related to the social insurance system and compulsory medical insurance.
In addition, a spouse or close relative can find out about the cause of death and the diagnosis of the patient when they receive the corresponding conclusion from Federal Law dated November 21, 2011 N 323-FZ.
How to prove the fact of disclosure of medical confidentiality
If you are injured, those responsible can be held accountable. But before that, you need to collect evidence of violation of your rights. The set here is standard: video recordings, audio recordings, testimony.
Please also attach data that confirms the damage resulting from the disclosure of the secret. For example, recording a conversation with a boss who insists that you write a letter of resignation of your own free will. Especially if he indicates the reason in it: he received a call from the hospital and was informed about your diagnosis.
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What liability is provided for the disclosure of medical confidentiality?
Cases where medical institution personnel are held accountable for disclosing secret data are not very high-profile, but they do exist. For example, in Perm a doctor was fired. The reason for the dismissal of the doctor was the disclosure of a secret protected by law for the fact that she passed on information about patients to third parties. And in Syktyvkar, a nurse became In Syktyvkar, a nurse will stand trial for disclosing medical confidentiality as a defendant in a criminal case for disclosing a diagnosis.
From the examples it is clear that responsibility varies.
- Disciplinary. An overly talkative hospital employee may be reprimanded or fired.
- Civil law. If the disclosure of medical confidentiality caused moral harm to the patient, he may demand monetary compensation.
- Administrative. Hospital employees who disclosed medical confidentiality are punished by the Code of Administrative Offenses of the Russian Federation Article 13.14. Disclosure of information with limited access is subject to a fine of 4 to 5 thousand rubles.
- Criminal. For the disclosure of medical confidentiality, the Criminal Code provides for the Criminal Code of the Russian Federation Article 137. Violation of privacy there are several types of punishment:
- a fine of 100–300 thousand rubles or in the amount of wages or other income of the convicted person for a period of one to two years;
- deprivation of the right to hold certain positions or engage in certain activities for a period of two to five years;
- forced labor for up to four years;
- arrest for up to six months;
- imprisonment for up to four years.
The severity of the punishment depends on the severity of the consequences the patient faced due to the disclosure of medical confidentiality, as well as the goals and motives of the hospital employee. For example, criminal liability is possible if a patient commits suicide due to a doctor’s violation of rules. Or the doctor sold information so that the person could be defamed. According to the Criminal Code of the Russian Federation, disclosure of medical confidentiality is not punished so often.
Qualifying features
Unfortunately, in Russian legislation, unlike the legislation of Kazakhstan, for example, there is no direct criminal regulation for violating medical confidentiality. The obligation of non-disclosure of medical confidentiality is contained in the norms of the Criminal Code of Ukraine and Belarus. However, it is possible to identify a number of elements of a crime that infringe on the privacy of private life and personal integrity.
The first main feature that distinguishes such crimes from other crimes is a special subject composition. Only a person who became aware of data about a patient only due to his professional activities can be punished.
Even in cases where the medical officer does not believe that he is committing a crime. A person in serious condition cannot give his consent to the disclosure of diagnosis or treatment methods, and the doctor can disclose such information only to close relatives or legal representatives. Grandfathers are not direct relatives to their grandchildren, so disclosing information about the condition of one of these entities without his consent may be illegal.
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How to get justice
A patient for whom a reprimand or dismissal would be enough for the violator should contact the chief physician of the clinic. To do this, you must submit a written complaint. It is better to print two copies and keep the second one with a note that it was accepted. The paper will be needed in the event of a trial as evidence that the victim tried to resolve the issue peacefully.
It is worth starting with the head physician even if the victim wants to compensate for moral damage. Then in a written complaint it is necessary to note what suffering he experienced and evaluate it in material equivalent. If the medical institution remains silent, the patient can file a lawsuit. The head physician has 30 days to respond to Federal Law No. 59-FZ dated May 2, 2006 (as amended on December 27, 2018) “On the procedure for considering appeals from citizens of the Russian Federation.”
When the administration covers up a violator, or the head physician himself has revealed a medical secret, or a patient wants to bring a clinic employee to administrative responsibility, it is necessary to contact the prosecutor’s office with a statement. It must contain:
- the name of the prosecutor's office to which the complaint is sent;
- Full name, registered address at the place of residence, contacts of the victim;
- date and signature.
If the patient has suffered greatly as a result of someone else’s talkativeness and is thirsty for blood, he should contact the Investigative Committee. They will open a criminal case there if there are grounds for this.
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What to remember
- A hospital employee is prohibited from disclosing information even about the fact of visiting the institution, not to mention the diagnosis and treatment.
- There are exceptions. But cases that fall under them are not so common.
- It is forbidden to tell your relatives about your illnesses.
- Children are also protected by the medical confidentiality law. Until the age of 15, parents or official guardians can receive information about their illnesses; after that, no one can receive information about their illnesses without the child’s permission.
- If your rights are violated, contact the head physician, the court, the prosecutor's office or the Investigative Committee.
Ethical considerations
Medical confidentiality is an important principle of medicine that all workers in this field are required to follow. Ethics assumes that maintaining a secret entrusted to another person is a mandatory condition when receiving a patient
This is very important because doctors have detailed information about a person’s health, his future prospects (whether he will remain in his current job after treatment, become disabled, etc.)
Many personal facts are transferred to doctors for the necessary diagnosis. And doctors have no right to disclose entrusted data to other persons, so as not to harm the patient in the future, including morally and ethically.
