Medical Secret: Definition. Responsibility for the disclosure of medical secrets

The development of the health care system in Russia is expected to significantly improve the quality of care provided. But not the least role is played by the regulation of the doctor-patient relationship, which, alas, remains in its infancy. Therefore, for many, medical mystery is a mysterious and unclear concept.

Medical Ethics

Doctors return lost health to people, but at the same time they become carriers of various personal information that helps to treat the patient. A person does not become frank on such topics with strangers, and the doctor needs to speak everything frankly. The problem is that, as a rule, it is an unfamiliar person who does not want to trust such personal information without guarantees that she will not go further. How to be?

To the aid comes medical ethics, or deontology. It regulates the relationship between the doctor and the patient, and it is she who should be guided by the staff in various controversial issues. It is believed that the basic principles of medical deontology formulated Hippocrates in his famous oath.

Medical ethics includes issues of responsibility for the health and life of patients, relationships with relatives of patients, as well as in the medical community in general, the admissibility of communicating with patients beyond the business. But the most relevant in recent years have become such topics as euthanasia and medical secrecy. These are really very serious problems, but their solution should be regulated not only by morality. This is especially true in the case of the last question.

What is a medical secret?

The definition of this concept is quite simple. Medical (medical) secret is all information that a medic receives during the treatment of a patient and can not transfer to third parties. It would seem that everything is unambiguous, but in fact everything is not so simple. Most patients have relatives, children, parents. After all, it's impossible for the mother of a one-year-old child to say that information about his health is not available to her? Or can the doctor be silent about the fact that his patient, for example, has seen signs of infection with the plague, because in this way he indirectly contributes to the epidemic? And what information specifically need to inform strangers there? All these are complex ethical issues, to which each person can offer his answers.

Fortunately, it has become clear quite a long time ago that without legal registration of these problems, it will not be possible to manage. Of course, this does not give a clear algorithm of actions in any situation, but it can set a framework on which to orient.

Legal regulation

The legislative basis of medical secrecy is derived from Art. 23, 24 of the Constitution of the Russian Federation, which protect the right to preserve personal and family information in secret. In addition, relatively recently entered into force is another legal act regulating the protection of information that the patient passes to the physician. This is the federal law No. 323-FZ of 21.11.2011, which indicates what is a medical (medical) secret and what constitutes the information included in it. There is also a judicial practice, although it is difficult to draw unambiguous conclusions from its analysis - it is simply very small.

As for the state of affairs in this area in Europe and the US, medical secrecy and patient information are regulated somewhat differently. In America there are no laws at the federal level, each state decides this issue in its own way. As for European states, the legal basis for the protection of personal information, including medical secrets, is contained in criminal codes, and their history dates back to the 17th century and earlier. Thus, to date, in some countries, for example, France and Germany, the regulation of the treatment of information transmitted from the patient to the doctor is sufficiently detailed and specific.

What is included in the confidential information?

Medical secret is, as it became clear, some personal information that the patient passes on to his doctor. And the Russian legislation specifies what exactly makes up this information:

• The fact of applying to a medical organization;
• The state of physical and mental health;
• Diagnoses and forecasts;
• Any other information reported by the patient or identified during the survey / treatment.

The main subjects, that is, persons who access personal data, are employees of the medical institution, including trainees and pharmacists, as well as those who receive such information from doctors, for example, investigators and other law enforcement officials.

And yet, under certain circumstances, the disclosure of medical information is completely legal. But they should be considered a little more.

Access to personal data

Non-disclosure of medical secrecy in the general case is the norm. However, there are circumstances in which information can be transferred to third parties. These include the following cases:

• Patient's age is less than 15 years. In this case, information about the state of his health is transmitted to parents or legal representatives.
• Disability. The patient can not express his will in connection with a physical or mental condition.
• There is a serious threat of the spread of an infectious disease.
• Investigation of accidents at work or in an educational institution.
• Transfer of information about the infliction of injuries to law enforcement agencies.
• With written consent - for scientific research.
• Exchange of information between medical institutions.
• Quality control of the assistance provided.
• At the request of law enforcement.

In some cases, relatives and close relatives of the patient can also access such information: by his written permission or without him, if he did not express a desire for the opposite, especially if the prognosis of his illness is extremely unfavorable. But medical ethics dictates the need to report information in the most delicate form.

Consequences of disclosure

It seems obvious why the medical secret is so important. The law protects the tranquility of citizens and punishes for unauthorized access to information of this nature. It also provides for liability, coming, if confidentiality has not been observed:

• Disciplinary , that is, a remark or reprimand from the employer, in serious cases, dismissal with the entry of an appropriate entry in the work book.
• Civil-law - monetary compensation to the affected patient.
• Administrative (Article 13.14 of the Administrative Code of the Russian Federation) - the imposition of a fine up to 5 thousand rubles.
• Criminal (Part 2, Article 137 of the Criminal Code), the maximum penalty - imprisonment for up to 5 years.

About the timeline

The current international and Russian legislation does not specify a specific period of time during which the disclosure of medical secrets is impossible. Of course, this does not apply to the above exceptional cases. The only thing that the legal acts define clearly - the death of the patient is not an occasion for disclosure of information, so that medical secrecy must be kept after the fact is established.

In Russia and abroad

In the post-Soviet space, unlike Europe and the United States, the legal regulation of access to medical information is still poorly developed. Despite the fact that the aforementioned laws have already been introduced, their observance is little controlled. At the same time, the introduction of an electronic card system and the complete abandonment of paper records are both a field for abuse by medical personnel, as well as the risk of breaking into databases and gaining access to personal data from outside. Probably, in case the implementation will correspond to the idea, the result will be excellent. But it is somewhat premature to talk about this, especially when it comes to health care facilities that are part of the CHI system.