Medical Confidentiality Principles

Principle of Confidentiality

• Based on loyalty and trust
• Personal, medical, and treatment details are maintained confidential
• Information disclosure requires full consent, except when clinically and legally required
• Disclose only what is necessary to benefit the patient or others

The Principle of Fiduciary

• A fiduciary acts in someone else's best interests with "openness, trust, and good faith"
• Moral or legal obligation to ensure safety or well-being of others
• "Duty of care" is a legal obligation to act in the best interest of individuals
• Standard of care is the reasonable action in a situation, differing from duty of care

Need for Medical Ethics

• Rising cost of hospitalization and litigations require higher standards of care
• Advances in technology raise ethical issues in human experimentation, organ transplantation, and stem cells
• Differences in attitude and objectives lead to debates and controversies

Principles in Medical Ethics

• Traditional Values:
  • Autonomy: right to decide, self-determination, and free will
  • Beneficence: actions promoting well-being of others, patient welfare first
  • Non-maleficence: "first do no harm," respect for sanctity of life
  • Justice: fairness, peace, and genuine respect for people
• Related Principles:
  • Veracity: truth-telling and honesty
  • Confidentially: maintaining personal and medical secrets
  • Informed Consent: patients have the right to know and decide
  • Fiduciary: acting in the best interest of patients

The Principle of Autonomy

• Right to decide, self-determination, and free will
• Capacity to think, decide, and take action
• Right to information and autonomy over one's own body

The Principle of Beneficence

• Actions promoting well-being of others
• Patient's welfare remains the first consideration
• Care, compassion, competence, and ensuring healthcare is affordable

The Principle of Non-Maleficence

• Concept: "first do no harm"
• Respect for the sanctity of life
• Calculate the risk-benefit ratio

The Principle of Justice

• Complex concept based on morality, law, religion, and theology
• Fair treatment of individuals and equitable allocation of resources
• Concern for fairness, peace, and genuine respect for people

Concept of Justice

• Differs in every culture, with various meanings and explanations
• Advocates of divine theory, Plato's theory, and John Locke's natural law

Justice as an Ethical Principle

• Fair treatment of individuals and equitable allocation of resources
• A concept versus a principle
• Social, procedural, and distributive justice

Discussions on Justice

• Social justice: fairness in religion, philosophy, and theology
• Procedural justice: fairness in the study and application of law
• Distributive justice: equitable distribution of scarce resources among socio-economic groups

Principle of Veracity

• Truth-telling and honesty in communication
• Accurate and true information promotes better patient-doctor relationships