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Disclosure of confidential information obtained during doctor-patient consultation (01HDC04859)

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(01HDC04859, 30 October 2001)

General practitioner ~ Ambit of confidential information ~ Breach of patient confidentiality ~ Right 4(2)

A prominent academic complained that his former GP had used information gained in doctor-patient consultations to form judgements about him, which were published in an article written by the GP.

In the 1980s, the patient attended the practice of the GP. At the time, there was ferment in the area of health policy, which was the patient's area of research. In the course of consultations, the doctor would raise and wish to debate changes occurring in the health arena. The patient, who tended to hold different views from the GP, found the GP's style insistent and combative, and so tried to avoid discussion. In the end, the patient felt that the disagreements intruded on the doctor-patient relationship, and decided to find another GP.

Some years later, the GP wrote about the patient in an opinion column of a publication read by GPs. In the article, the GP discussed research and funding issues with which the patient was involved at that time, and called into question the patient's suitability and objectivity in undertaking the research in question.

The patient did not take issue with the GP's right to hold and express an opinion; what he did object to was what he saw as the use of "information gained in the privileged confines of the doctor-patient relationship to attack a former patient".

In upholding the complaint, the Commissioner identified the following key issues:
1) Information disclosed in the course of a doctor-patient consultation is subject to a duty of confidentiality, except where the law, public interest, or matters of safety require. A decision to break confidentiality should not be taken lightly.
2) The ambit of confidential information extends beyond the specific medical matters under discussion. Seemingly unrelated conversation may be required to establish the relationship of trust between doctor and patient and may inform exactly how the medical situation is affecting the patient.
3) Patient confidentiality is covered by the Health Information Privacy Code and the New Zealand Medical Association's Code of Ethics, and thus is a legal and ethical duty which falls under the ambit of Right 4(2) of the Code of Health and Disability Services Consumers' Rights.
4) If the material explicitly draws on and refers to information gained in doctor-patient consultations, it is no defence that the material is already available in the public domain.