Beyond all the theoretical and practical preparation that every doctor needs before starting to practice, there are also issues that deserve even more attention in the exercise of the profession. One of these issues is medical ethics.
During undergraduate and postgraduate studies, doctors are introduced to ethics more than once, but it is only during actual practice that they understand the true application of ethics and its nuances.
When we talk about professional confidentiality, for example, it seems very obvious that a doctor cannot share information about their patients with third parties, but what about when it comes to treating a minor? When and why can confidentiality be broken?
In this article, you will understand what medical confidentiality is, its importance, exceptions, and which laws and regulations require attention.
What is professional secrecy?
Professional confidentiality in medicine is an ethical and legal obligation, present in the Medical Code of Ethics established by the Federal Council of Medicine (CFM), to keep patient health information confidential. This includes: personal data, medical history, diagnoses, and treatments.
This is a measure that prevents the doctor from disclosing any information to third parties without the patient's express authorization, except in some cases, such as when the patient is a minor, even if the third parties in question are spouses or family members.
How important is professional confidentiality?
It can be said that professional confidentiality is one of the pillars that support the doctor-patient relationship, which is based primarily on trust. Without this principle, the entire medical process could be compromised, from diagnosis to treatment.
This is because, if the patient withholds any information about their condition, the diagnosis may be inaccurate or completely misrepresent the real problem.
What does the law say about professional secrecy?
Article 73 of the Medical Code of Ethics stipulates that physicians are prohibited from:
"Disclose information that one has learned by virtue of exercising one's profession, except for just cause, legal duty, or written consent from the patient."
The prohibition remains even if the patient in question dies, or if the doctor is a witness in an investigation or a suspect in a crime. Similarly, the doctor must maintain confidentiality even if the information becomes public.
Furthermore, the physician should not share information about a minor patient unless withholding the information would cause harm to the patient. The physician should also not share or refer to identifiable clinical cases.
Regarding legal regulations, the right to keep one's information confidential is a right established for patients by the Federal Constitution, which states in article 5, item XIV:
"Everyone is guaranteed access to information, and the confidentiality of sources is protected when necessary for the exercise of their profession.".
Furthermore, violating a patient's right to the confidentiality of their personal information is punishable by imprisonment for 3 months to 1 year, or a fine, according to Article 154 of the Penal Code.
Professional confidentiality in telemedicine
In general, telemedicine should follow the same rules as in-person services. That is, it must also respect professional confidentiality and preserve the patient's integrity.
In this case, the Federal Council of Medicine (CFM) further reinforces, according to Article 3 of CFM Resolution 2.314/2022, that:
"In telemedicine services, patient data and images contained in medical records must be preserved, complying with legal and CFM (Brazilian Federal Council of Medicine) regulations regarding the safekeeping, handling, integrity, accuracy, confidentiality, privacy, irrefutability, and guarantee of professional secrecy of information.".
In this context, telehealth services are subject to compliance with the LGPD (Brazilian General Data Protection Law). Furthermore, these measures are implemented through an Electronic Health Record System (SRES) approved by the CFM (Federal Council of Medicine).
Under what circumstances can professional confidentiality be broken?
When expressly authorized by the patient or one of their legal guardians, professional confidentiality may be broken. However, the same can happen if there is suspicion of a crime.
Among these situations, we can mention suspected abuse or assault against minors, the elderly, or spouses. This also includes cases of suspected injury resulting from a criminal act or injuries caused by firearms and similar weapons.
The physician may also disclose information about the diagnosis of communicable diseases to health authorities when this is of concern or scientific importance.
More detailed specifications regarding exceptions to professional confidentiality can be found in the Medical Code of Ethics.
Medical ethics and professional confidentiality
In general, preserving medical confidentiality goes beyond an ethical obligation; it is a legal obligation regulated by the Federal Constitution and the Penal Code. But, more than an obligation, it is a way to preserve the safety and trust of the patient and to respect the profession.
The information used to construct this article was obtained from the Medical Code of Ethics, the Federal Constitution , and the Penal Code, updated to the date of publication and subject to change.
