LE FIGARO – What are Medical confidentiality limits?

Prof. Jean-Marie FAROUDJA. – Medical confidentiality is general and absolute, even after the patient’s death. Only certain exemptions are provided for by law: obligation to report births and deaths, beatings, work accidents, etc.

If the patient is suffering from a contagious disease or if the condition is likely to cause an accident (eg, incompatible with driving visual disturbances), her doctor must do everything to convince her to take the necessary measures. But in any case it can overcome the confidentiality and issue to the environment or administration sensitive information it has. The patient herself cannot release the doctor from this obligation.

Can the doctor sometimes overcome this obligation?

There is a tolerance if the doctor strongly believes that his patient is dangerous and presents an immediate danger. Thus, if the patient says, “I have a loaded gun and I will kill my employer,” the doctor is allowed to depart from medical confidentiality and inform authorities. [Generally in the U.S. this is a legal requirement.]

However, the patient can seek to overrule the medical decision and petition the legal system. The doctor will explain to the court why he made the decision regarding the patient, in all conscience, it was his duty to waive the obligation of confidentiality.

Why is patient confidentiality so important?

The patient’s trust in the physician must be absolute, as it is with a priest as part of confession. If the doctor is likely to be relatives, employer, etc. the things said in consultation, the patient may not be forthcoming and will not be supported. That would be the most critical of situations.