2023-04-28 14:06:08
Medical secrecy is one of the main pillars of medicine. All health professionals must submit to it, in accordance with the Hippocratic Oath which stipulates: “Admitted in the privacy of persons, I will keep secrets that will be entrusted to me. Received inside the homes, I will respect the secrets of the homes and my conduct will not be used to corrupt morals” (source 1). Concretely, doctors are prohibited from divulging elements relating to the health of a patient without his permission. However, there are a few exceptions…
Definition: what is medical secrecy? Who is entitled to it?
Medical secrecy is a fundamental ethical principle that commits health professionals to not to disclose information relating to the health of their patients without their consent. It covers in particular:
- patient’s personal data, such as their age, contact details, profession, etc. ;
- information relating to the patient’s state of health, such as medical history, symptoms, test results, current or past treatments, sequelae, etc. :
- patient privacy information, such as their sexual orientation and sexual practices, religion, beliefs, etc. ;
- information relating to the patient’s family and friendssuch as the medical history of their relatives;
- and related findings and deductions made by doctors (what they saw, heard, understood, etc.).
In other words, medical secrecy allows patients to trust their doctor and receive appropriate care without fear of seeing the information in their medical file disclosed to third parties.
Medical secrecy also concerns minors!
This does not necessarily go without saying, but medical secrecy also applies to minorswho can refuse to allow their parents to be consulted or informed in order to keep their state of health secret.
A practical example: if a doctor sees an adolescent who has alcohol or drug problems, and this teenager does not want his parents to know, he must not disclose anything. In which case he would violate medical secrecy – therefore the law. However, the doctor must try to reason with the adolescent and explain to him the advantages of informing his parents. And if the young person refuses, then he/she must be accompanied by an adult of their choice.
Good to know: confidentiality can be waived in certain situations where the well-being of young people is threatened, such as in case of suspicion of abuse or neglect. In this case, professionals have a legal obligation to report to the competent authorities.
Professional secrecy or medical secrecy: what are the differences between the two?
In reality, there is no difference between medical secrecy and professional secrecy. Professional secrecy is a general principle which applies to all professions involving a relationship of trust between a professional and a person who entrusts him with confidential information (in terms of health, private life, finances, etc.).
The notion of professional secrecy is therefore very broad and can relate to many professions, such as lawyers, psychologists, social workers, religious people, journalists and health professionals. The notion of medical secrecy is specific to health professionals.
What is the law governing medical secrecy?
In France, medical secrecy is governed by the Public Health Codemore precisely by article L.1110-4 which states that “any person taken in charge by a professional, an establishment, a health network or any other organization involved in the prevention and care has the right to respect for his private life and the secrecy of information concerning him ».
Other legislative and regulatory texts also regulate medical secrecy, such as the data protection act et Codes of Ethics doctors, nurses, physiotherapists-masseurs, podiatrists-pedicures and psychomotricians.
Which professionals must respect medical secrecy?
As stated above, all health professionals are subject to medical secrecywhatever their specialty and their mode of practice (consultations in office, hospital, nursing home, home visits, etc.):
- THE general practitioners and specialists (surgeons, paediatricians, gynecologists, etc.);
- THE nurses ;
- THE midwives ;
- THE pharmacists and the pharmacy assistants ;
- THE psychologists and psychiatrists ;
- THE physiotherapists ;
- THE dentists ;
- THE medical auxiliaries (speech therapists, orthoptists, etc.);
- THE laborantins ;
- etc.
Good to know : medical students, the trainees and the other professionals in training are also required to respect medical secrecy! Similarly, people who work in the entourage of health professionals, such as medical secretaries or social workersmust hold their tongues.
What is shared medical confidentiality?
Shared medical secrecy refers to the possibility of partially lifting medical secrecy to allow good coordination of care between several health professionals involved in the care of a patient.
Concretely, this allows several healthcare professionals to access a patient’s medical information, while guaranteeing the confidentiality of this information. The professionals concerned only have access to the information they need to ensure continuity of care.
In France, shared medical secrecy is governed by the law of 26 January 2016 on the modernization of our health system, which introduced the concept of “information sharing between healthcare professionals” (PIPS). This text defines the terms and conditions for sharing medical information between healthcare professionals, in particular with regard to the conditions of security and confidentiality, as well as the terms of access and use of shared medical data.
Derogation: when can medical secrecy be lifted?
Medical secrecy may be waived in certain exceptional situations, such as:
- when patients give their express and informed consent to have their medical information disclosed to third parties. Said consent must, however, be given in a free, informed and specific manner to the situation concerned.
- when the lifting of medical secrecy is necessary under a legal provision, for example, to report a contagious disease, mistreatment or violence, an internment certificate, a declaration of birth or death, autopsy, etc. ;
- when the life of patients or others is in dangerfor example in the context of a legal inquiry, or in the event of a serious prognosis (the family, relatives or trusted person can receive the information necessary to support the patient, unless the patient objects).
In any case, the lifting of medical secrecy must be strictly proportionate to the situation and limited to necessary information.
Can doctors communicate information to an insurer, a banker or an employer?
Non, physicians have absolutely no right to disclose personal health information to any insurance company, bank or employer. For good reason, this may lead to discrimination.
It is everyone’s responsibility to answer honestly the various questions that may be asked. But anyway, the doctors cannot communicate medical information directly to an insurer, employer or banker without the express consent of the patient. Furthermore, an insurer cannot demand medical information or documents about you.
Does medical secrecy still apply after death?
Yes, in principle, medical secrecy still applies after the death of a patient. The medical information of a deceased person remains protected by medical secrecy and may only be disclosed if there is a valid reason: for know the causes of death or for defend the memory of the deceasedFor example.
Violation of medical secrecy: what are the penalties?
Healthcare professionals who breach medical secrecy may be subject to disciplinary and legal sanctions heavy for malpractice. Even here, as indicated above, medical secrecy is not absolute and may be lifted in certain specific cases, such as in the context of a legal investigation or to protect public health.
On the disciplinary level, health professionals who violate medical secrecy may be sanctioned by the professional order on which they depend. These sanctions can range from a simple warning to disbarment. In addition, they can be sued by a patient or by third parties who believe they have suffered damage as a result of the breach of medical secrecy.
According to the Penal Code, the violation of medical secrecy is considered as an offense that can be punished by a fine and/or imprisonment. The disclosure of information covered by medical secrecy is punishable by a maximum penalty of one year’s imprisonment and a fine of 15,000 euros. The penalty may be increased depending on the circumstances, such as whether the disclosure caused significant harm to the data subject.
How to lodge a complaint in the event of a violation of medical secrecy?
If you believe that a professional has violated medical secrecy, know that you have legal recourse!
- You can contact a police station or a gendarmerie brigade of your choice to lodge a complaint. Receipt of the complaint cannot be refused to you and it will then be forwarded to the public prosecutor.
- You can also send a letter directly to the public prosecutor or to a specialized Order to denounce the fault and lodge a complaint. Write the letter on plain paper to the court of law at the place of the offense or the domicile of the offender (sample letter here).
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