ABA Family Legal Guide

Health-Care Law

Patients' Rights

Confidentiality and Privacy

Can doctors ever give my personal medical information to others without my permission?

In theory, you have the right to dictate which people can and cannot see your medical information. In the real world, doctors, nurses, and other health-care workers have considerable discretion in releasing your personal information. Doctors may, for example, release your personal information in the circumstances set out below.

You Are Unconscious

If you are unconscious or unable to make decisions regarding your care, the doctor has the right to provide your family members with all the information necessary to make an informed decision on your behalf. Otherwise, doctors should use only very general terms, such as "stable," when describing your condition.

Many people have anticipated that at some point in the future they might not be able to make decisions and have written and signed a living will, a health-care advance directive, a durable power of attorney for health care, or a health-care proxy. Through any of these devices, you can appoint a health-care agent to make decisions for you. If you have such a document, then that person alone is entitled to information regarding your medical condition. The chapter on the Rights of Older Americans can provide you with more information on your options in this area.

Reporting Vital Statistics

Just as the law requires some information to be kept under wraps, it also requires doctors, nurses, and other health professionals to release information in certain circumstances. For instance, most states have laws requiring doctors to file birth and death certificates. Doctors are also usually required to report injuries caused by guns or sharp instruments, such as knives.

When There Is Abuse or Danger to Others

There is a duty to protect that is spelled out by law in many states. For instance, when child abuse is suspected, doctors, nurses, and other health professionals must report the abuse. The same is true for situations when a doctor or therapist decides that the patient is a danger to others.

When You Have a Communicable Disease

Many states require doctors to report cases of communicable diseases, including smallpox, tuberculosis, pneumonia, measles, chicken pox, mumps, syphilis, gonorrhea, AIDS, and HIV. AIDS and HIV present a special challenge to patient privacy and confidentiality. Some states use unique identifiers in their records rather than names.

In general, confidentiality is needed so that people will be comfortable being tested for AIDS or HIV. That need for confidentiality must be balanced with the desire to protect others from contracting the disease. While doctors in all states are required to report AIDS cases to state public health departments, states differ in how this information is used.

In Legal Proceedings

Any time you make your health or physical condition the focus of a lawsuit, such as a suit for workers' compensation, injuries from a car accident or medical malpractice, and in some child custody cases, your doctor can be brought into court to testify about your medical condition, even when privilege exists between the doctor and the patient. Of course, if your medical condition is not really an issue during the proceeding, privacy rights do prevail.

With Other Doctors

A doctor is allowed to discuss a patient with health-care professionals who are not involved in the patient's care, but only if the patient consents or the doctor doesn't reveal the patient's identity. In other circumstances, you have a right to maintain your privacy. For example, imagine that a doctor shows up to examine you—and is trailed by a group of medical students. You have the right to refuse to let the medical students watch your examination.