Confidentiality and privacy

Abstract

Secrecy has always been a part of patient care. Already at the dawn of western medicine, not telling others what the doctor might know about his patient was considered a requirement of good practice. A substantial change that has occurred in recent decades is the transformation of secrecy into a citizen’s right. Recognition of the personal autonomy of the patient forms the basis of his right to consent to, or reject, the proposals of the health professionals, and also to decide who can have access to his personal data and what limits he imposes on the handling of his body. Nonetheless, the intimacy of patients frequently continues to be violated, perhaps because we live in a society that trivialises these questions, and the health milieu is not immune to this way of thinking. Besides, the new information technologies have added a new danger by enormously facilitating access to personal data. This article reviews the ethical and legal aspects of this issue, the results of research carried out on the way the professionals of eight Spanish hospitals deal with confidentiality, and some recommendations are outlined in an attempt to encourage reflection by the professionals who interact in a scenario where the patient is obliged to lay himself bare in body and soul.