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Patient perspectives on medical confidentiality

A review of the literature

  • Review
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Abstract

OBJECTIVE: To lay the groundwork for a better understanding of patient views on medical confidentiality.

DESIGN: Studies were found by searching MEDLINE, BIOETHICSLINE, and selected bibliographies. Articles concerning physician perspectives or implications of legal and administrative regulations were excluded. Only peer-reviewed journal articles reporting original research on patients’ confidentiality views and conduct were included.

MAIN RESULTS: Many patients are unaware of or misunderstand their legal or ethical right to medical confidentiality protections, which leads them to both over- and underestimate confidentiality protections. The possibility that medical information might be revealed, intentionally or not, to acquaintances in a clinic or other social community troubles patients as much as information release to insurers or employers. A significant minority of patients distrust confidentiality protections, leading some to report that they delay or forgo medical care. If doubtful that confidentiality will be upheld, patients will act independently to protect information.

CONCLUSIONS: Our review found a wider variety of understandings and beliefs about medical confidentiality among patients than are often indicated in the writings of practitioners or legal experts. As medical confidentiality regulations evolve, these differences need to be recognized and accounted for in interactions between practitioners and patients.

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Authors and Affiliations

  1. General Internal Medicine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.

    Susan Moran MD

  2. Center for Bioethics, University of Pennsylvania, 3401 Market St., Suite 320, 19104-3308, Philadelphia, PA

    Pamela Sankar PhD, Jon F. Merz JD, PhD & Nora L. Jones PhD

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  1. Pamela Sankar PhD
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  2. Susan Moran MD
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  3. Jon F. Merz JD, PhD
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  4. Nora L. Jones PhD
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Correspondence to Pamela Sankar PhD.

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This work was supported by The Charles E. Culpeper Foundation.

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Sankar, P., Moran, S., Merz, J.F. et al. Patient perspectives on medical confidentiality. J GEN INTERN MED 18, 659–669 (2003). https://doi.org/10.1046/j.1525-1497.2003.20823.x

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