Sharing personal information: how to decide whether to or not.

©FSRH J Fam Plann Reprod Health Care 2010: 36(3) Introduction Without assurances about confidentiality, clients (confiders) may be reluctant to give health professionals (confidants) the information they need in order to provide good care. In a European Court of Human Rights case, a woman’s doctor had been compelled to reveal her HIV positivity in court in connection with the investigation of sexual offences committed by her husband. Also her complete medical records had been seized. In this case the judges said that: “Respecting the confidentiality of health data is a vital principle in the legal systems of all [countries]. It is crucial not only to respect the sense of privacy of a patient but also to preserve his or her confidence in the medical profession and in the health services in general. Without such protection, those in need of medical assistance may be deterred from revealing such information of a personal and intimate nature as may be necessary in order to receive appropriate treatment, and, even, from seeking such assistance, thereby endangering their own health and, in the case of transmissible diseases, that of the community”.1 Clients should be made aware that there are exceptions to keeping confidences and a general idea of what these are. Confidentiality is overwhelmingly an ethical principle, with health professionals bound by professional codes.2,3 But, legally, there is a public interest in the protection of confidential information received in circumstances that import a duty of confidentiality.4 There is substantial statute law (made by Parliament) and case law (made by judges in courts) on confidentiality that clinicians need to be aware of. Two European influences have had significant impact on current practice. The first is EC Directive 95/46/EC which brought about the Data Protection Act 1998. The Data Protection Act 1998 goes much wider than the Data Protection Act 1984. Data protection is comprehensively covered by Faculty guidance5 and this article will concentrate mainly on other aspects of confidentiality. The second European influence has been the European Convention on Human Rights.6 Article 8 of the Convention states that “everyone has the right to respect for his private and family life, his home and his correspondence”. Article 8 essentially boils down to the right of privacy, and this right to privacy strengthens the legal basis of confidentiality. The Human Rights Act 1998 renders the Convention Articles enforceable against public authorities, which includes the National Health Service. A European human rights case concerning the sexual orientation of a Northern Irish man suggested that the more intimate the issue in question, the stronger the protection of privacy that is needed.7 Sharing personal information: how to decide whether to or not