Medical Confidentiality and The Importance of Patient Consent.

Richard Sobel & Graham L. Spruiell

This presentation will discuss the nature and importance of medical confidentiality and informed consent in the use of patient information to the quality of care and strength of the doctor/patient relationship. It will briefly review the history of confidentiality rooted in the Hippocratic oath and modern medical ethics. It will identify the importance for quality care of patient's sense of trust that what s/he reveals to a provider will be kept confidential and used only to maintain or restore a person's health. This trust is essential for patients to reveal complete symptoms needed for accurate diagnoses and to avoid the risks of physician's acting on incomplete information. The presentation will emphasize the importance of confidentiality for psychiatry and other psychological counseling. It will also discuss a medical confidentiality tutorial developed for the Patient/Doctor III course during fall 2002.

The presentation will also discuss the HIPAA regulation on patient medical information and the extent they might contribute to or undermine confidentiality for providers who transmit "protected health information" electronically. In particular, it will discuss the detrimental impact on patient care of the dropping of the consent requirement from the HHS medial records regulations promulgate in fall 2002 (see R. Sobel, "No Privacy for All? Serious Failings in the HHS Medical Records Regulations," J. Biolaw & Business, Spring 2002; "A New Wound for Medical Privacy," Los Angeles Times, August 24, 2002.) It will discuss what providers, patients and institutions may do to strengthen confidentiality and consent.