Ethics Opinions

Physicians have a responsibility to protect the confidentiality of minor patients, within certain limits. In some jurisdictions, the law permits unemancipated minors to request and receive confidential services relating to: contraception, pregnancy testing, prenatal care, delivery services and care to prevent, diagnose, or treat sexually transmitted disease, substance use disorders, or mental illness.

Respecting patient privacy is a fundamental expression of respect for patient autonomy and a prerequisite for trust. Patient privacy includes personal space (physical privacy), personal data (informational privacy), personal choices, including cultural and religious affiliations (decisional privacy), and personal relationships with family members and other intimates (associational privacy). Physicians must seek to protect patient privacy in all settings to the greatest extent possible.

When individuals who are not involved in providing care seek to observe patient-physician encounters, physicians should safeguard patient privacy by permitting such observers to be present only when the patient has explicitly agreed to the presence of the observer(s), the presence of the observer will not compromise care, and the observer has agreed to adhere to standards of medical privacy and confidentiality.

Audio or visual recording of patients can be a valuable tool for educating health care professionals, but physicians must balance educational goals with patient privacy and confidentiality. Physicians also have an obligation to ensure that content is accurate and complete and that the process and product of recording uphold standards of professional conduct.

Audio or visual recording of patient care for public broadcast is one way to help educate the public. However, physicians have an obligation to protect patient interests and ensure that professional standards are upheld. Physicians also have a responsibility to ensure that information conveyed to the public is complete and accurate.

Ensuring that the public is informed promptly and accurately about medical issues is a valuable objective. However, media requests for information about patients can pose concerns about patient privacy and confidentiality, among other issues.

Information gathered and recorded in association with the care of a patient is confidential, regardless of the form in which it is collected or stored.

When there is reason to believe that patients’ confidentiality has been compromised by a breach of the EMR, physicians have a responsibility to follow ethically appropriate procedures for disclosure. The degree to which an individual physician has an ethical responsibility to address inappropriate disclosure depends in part on his or her awareness of the breach, relationship to the patient(s) affected, administrative authority with respect to the records, and authority to act on behalf of the practice or institution.

In handling patient data, individual physicians should balance supporting and respecting patient privacy with upholding their ethical obligations to the betterment of public health. The use of data for the benefit of public health should be treated as a form of public good in which the standards and values of health care should follow the data and be upheld and maintained. Those with access to datasets have a duty to uphold the ethical values of health care in which the data were produced.

Donating eggs or sperm for others to use in reproduction can enable individuals who would not otherwise be able to do so to have children. However, gamete donation also raises ethical concerns about the privacy of donors and the nature of relationships among donors and children born through use of their gametes by means of assisted reproductive technologies.