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Student Careers

From medical student to junior doctor: rules of confidentiality

BMJ 2006; 333 doi: https://doi.org/10.1136/sbmj.0610377 (Published 01 October 2006) Cite this as: BMJ 2006;333:0610377
  1. Geoffrey Robinson, general physician1,
  2. Sarah Aldington, senior research fellow1,
  3. Richard Beasley, general physician1
  1. 1Medical Research Institute of New Zealand, Wellington, New Zealand

Patients have a right to confidentiality, but in some instances the rules must be broken. Geoffrey Robinson and colleagues explain, in the penultimate article of the series

Patients have a right to expect that information about them will be kept in strict confidence by their doctors. As part of the privilege of the doctor-patient relationship, the doctor has a responsibility to protect the patient's right to confidentiality. This has led to a series of rules that doctors must be aware of and follow in their clinical practice.14 But, as for all rules, circumstances exist when they may be broken for good reason, and doctors must also be aware of these exceptions.

Junior doctors in particular must be familiar with the issues surrounding patient confidentiality. From time to time they are given particular information that has not been disclosed to other health carers, and, on occasion, the patient expressly limits the possession of that information to the junior doctor.

Rights and responsibilities

Being registered as a medical practitioner gives doctors rights and privileges. In return, doctors have a duty to meet standards of competence, care, and conduct. This includes maintaining patients'confidentiality, which is central to the trust between doctors and patients. Without the assurance of confidentiality, patients may be reluctant to provide comprehensive information required for optimal health care. It has been proposed that the doctor-patient relationship may be interpreted as an agreement in which the doctor guarantees confidentiality (secrecy and discretion) in exchange for the confidence and honesty of the patient.5

It is often taken for granted that patients give “implied consent” to medical information being disclosed to others for “healthcare purposes.” Regardless, junior doctors should remember the standard of not divulging medical information without the consent of the patient-even routine matters of referrals and discharge summaries should be mentioned …

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