We all have to go to doctors. The reason for seeking medical help is always not the most pleasant. But sometimes the reason is purely personal. In this case, we do not want others to know that we are seeking medical help. This may be due to both the disease itself (venereal disease, HIV infection, etc.) and the circumstances that brought us to the doctor (for example, defects in appearance, pregnancy, etc.).
First, let's look at the term “medical confidentiality”; what is it?
Medical confidentiality is information about the fact that a citizen has applied for medical care; information about the citizen’s state of health and his diagnosis; other information obtained during medical examination and treatment of a citizen.
It is important to know that medical confidentiality applies, including after the death of a person. If a patient has died, this does not mean that the circumstances of his request for medical help can be freely disclosed.
Medical confidentiality is protected by the Constitution of the Russian Federation and Federal Law No. 323-FZ of November 21, 2011 “On the fundamentals of protecting the health of citizens in the Russian Federation.” Article 23 of the Constitution of the Russian Federation establishes the right of everyone to privacy, personal and family secrets. Article 13 of Federal Law No. 323-FZ of November 21, 2011 “On the fundamentals of protecting the health of citizens in the Russian Federation” speaks of the inadmissibility of disclosing medical confidentiality.
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Who is obliged to maintain medical confidentiality?
This may be news to some, but medical confidentiality is required to be observed not only by physicians (doctors or nurses), but also by any employees to whom it has become known due to the performance of work, official duties, official duties or training. Such workers include, for example, medical receptionists or hospital administrators (girls at the reception desk), lawyers, hospital accountants who also work with medical documents, inspectors and controllers, and medical students. In a word, all those employees into whose hands medical documents fall.
What needs to be done to prevent medical confidentiality from falling into the wrong hands?
Upon admission to the hospital, each patient signs a document - informed voluntary consent to medical care. As a rule, this is a standard form. It should include a section where the patient’s consent to transfer medical confidentiality to other persons is indicated. In this section, the patient either names the person to whom medical confidentiality can be transferred, or puts down about. In the second case, the doctor should not even disclose information about the patient’s health status to relatives. In the informed voluntary consent, you can make a reservation about the persons to whom medical confidentiality can be transferred after death. This is especially important when the patient is hospitalized and undergoes complex surgery.
Informed voluntary consent specifically stipulates the right of physicians to disclose medical confidentiality for the purposes of medical examination and treatment to third parties (for example, consultant doctors of other hospitals), as well as for the purpose of scientific research and publication of the results of such research.
Written consent for data availability
To obtain public access to patient data, doctors must have the patient's permission. And in writing. To do this, the document must include:
- Full name, address, identification document number, information about who and when it was issued.
- Full name and address of the citizen who received consent to access personal data.
- The purpose for which medical confidentiality is revealed.
- A list of exactly what personal information is accessible (diagnosis, treatment, etc.).
- A list of actions that a citizen who has received permission can subsequently perform.
- The specified period during which the permit is valid and the procedure for revocation.
At the same time, a citizen who has gained access to personal data cannot distribute it further unless there is additional written permission. In this case, he is obliged to keep the information received and maintain medical confidentiality. Access can be provided either partially to some data or completely to all information.
When does a doctor have the right to disclose medical confidentiality without the patient’s consent?
The law establishes cases when medical confidentiality is disclosed without the patient’s consent.
Without the patient's consent, medical confidentiality is disclosed:
- for the purpose of conducting medical examination and treatment when the patient’s condition does not allow expressing consent or refusal;
- when there is a threat of the spread of infectious diseases, mass poisonings and injuries;
- at the request of law enforcement agencies or the court;
- when monitoring persons with drug addiction;
- when providing medical care to a minor;
- when informing internal affairs bodies in established cases (for example, a crime has been committed against a patient (gunshot wound, injury, etc.); the patient has lost his memory and cannot identify himself and other similar cases);
- for the purpose of conducting various types of examinations;
- in order to control the quality and safety of medical activities and the expenditure of budget funds.
In addition, in the event of an unfavorable prognosis for the development of the disease, information about the state of health can be transferred to a spouse or one of the close relatives. The exception is cases when the patient has prohibited the transfer of this information to them in his informed voluntary consent, or if the patient has indicated another person to whom such information can be communicated.
In the cases mentioned above, there is no legal liability for the disclosure of medical confidentiality. In all other cases, legal liability arises for the disclosure of medical confidentiality.
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What responsibility is established for disclosing medical confidentiality?
Criminal liability under Article 137 of the Criminal Code of the Russian Federation. The maximum penalty is imprisonment for up to 5 years with deprivation of the right to hold a certain position or engage in certain activities for a period of up to 6 years.
Administrative liability under Article 13.14 of the Code of Administrative Offenses of the Russian Federation. Punishment for citizens in the amount of 500 to 1,000 rubles. For officials - from 4,000 to 5,000 rubles. The case is initiated by the prosecutor.
Civil liability in the form of recovery of material damage or moral damage. Both material damage and moral damage will have to be proven in court.
How to get justice
A patient for whom a reprimand or dismissal would be enough for the violator should contact the chief physician of the clinic. To do this, you must submit a written complaint. It is better to print two copies and keep the second one with a note that it was accepted. The paper will be needed in the event of a trial as evidence that the victim tried to resolve the issue peacefully.
It is worth starting with the head physician even if the victim wants to compensate for moral damage. Then in a written complaint it is necessary to note what suffering he experienced and evaluate it in material equivalent. If the medical institution remains silent, the patient can file a lawsuit. The head physician has 30 days to respond to Federal Law No. 59-FZ dated May 2, 2006 (as amended on December 27, 2018) “On the procedure for considering appeals from citizens of the Russian Federation.”
When the administration covers up a violator, or the head physician himself has revealed a medical secret, or a patient wants to bring a clinic employee to administrative responsibility, it is necessary to contact the prosecutor’s office with a statement. It must contain:
- the name of the prosecutor's office to which the complaint is sent;
- Full name, registered address at the place of residence, contacts of the victim;
- date and signature.
If the patient has suffered greatly as a result of someone else’s talkativeness and is thirsty for blood, he should contact the Investigative Committee. They will open a criminal case there if there are grounds for this.
