“I need a note, doctor”: dealing with requests for medical reports about patients
BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b175 (Published 03 February 2009) Cite this as: BMJ 2009;338:b175
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In Peter D Toon’s article about dealing with requests for medical
reports about patients (BMJ 2009; 338: b175) he mentions that patients may
imply consent for the information to be disclosed to a third party by
requesting the report. In the MDU’s experience, patients may not always
understand or appreciate the amount or type of information that will be
disclosed in medical reports, such as those needed to obtain life
insurance or for occupational health reasons, and this can lead to
complaints.
Doctors have an ethical duty of confidentiality to their patients and
need, in all but exceptional circumstances, to have their consent before
releasing medical information to third parties. The GMC advises that
doctors obtain patient’s consent before writing such reports, explaining
the purpose of the report and the scope of disclosure.1
As the article points out, legislation does not always cover a
patient’s right to see a medical report however, the GMC advises that:
“doctors should offer to show patients the report, or give them copies,
whether or not this is required by law.”2. In addition, a GP preparing a
medical report for a patient for employment or insurance purposes is
obliged under the Access to Medical Reports Act 1988 to give the patient
an opportunity to see the report before it is sent to the requesting
organisation.
Doctors are bound by their ethical duty to be honest and trustworthy
when completing reports and to do their best to ensure any documents they
write or sign are not false or misleading. If a doctor agrees to provide
a report, he or she should do so without unreasonable delay.3 Writing
reports and signing certificates are areas which can often lead to ethical
dilemmas about disclosing confidential information. Members can contact
the MDU for help in resolving these dilemmas.
References
1 Confidentiality: Protecting and Providing Information, General Medical
Council, April 2004, paragraph 17.
2 ibid
3 Good Medical Practice, General Medical Council, November 2006,
paragraphs 63, 65, 66
Competing interests:
None declared
Competing interests: No competing interests
Re: Patient consent needed for medical reports
Dr Old is of course absolutely right that free, full and informed
consent to disclosure is essential for all medical reports, and that, as
I have pointed out in this article and elsewhere, patients often do not
know what is in their notes or what consent to disclosure implies.
There is a need for much clearer and more explicit information to
patients and to third parties about these reports, what expectations are
reasonable, and the policies which doctors adopt on disclosure and
advocacy. The drafting of such policies and their validation in practice
is planned as the next stage in the research programme which led to this
paper.
Competing interests:
None declared
Competing interests: No competing interests