eMJA: Confidentiality

Letters

Confidentiality

Peter C Arnold

MJA 2002 177 (1): 165

To the Editor: Perhaps for reasons of space, Tobin et al, in their article on community versus individual benefit,1 have omitted an important public health justification for confidentiality. If patients are fearful that the doctor's obligation to notify the authorities could lead to a loss of privileges (in the case cited, a driver's licence), they may fail to attend for diagnosis and treatment. This understandable anxiety warrants a mention in this debate.

PO Box 280, Edgecliff, NSW.

Peter C Arnold, Retired general practitioner.

Correspondence: Dr Peter C Arnold, PO Box 280, Edgecliff, NSW 2027. parnoldATozemail.com.au

Tobin MT, Leeder SR, Somerville ER. Community versus individual benefit. Med J Aust 2002; 176: 279-280. <eMJA full text> <PubMed>

(Received 19 Mar 2002, accepted 22 May 2002)

Bernadette M Tobin, Steven R Leeder and Ernest R Somerville

In reply: Arnold makes a good point. We agree with him, and would resist today's increasing tendency, on public health grounds, to make it mandatory for doctors to report a variety of conditions suffered by their patients. In general the community is well served if doctors have the discretion to decide, in any particular case, whether the public interest in maintaining a patient's confidentiality is outweighed by the public interest in breaching that confidentiality in order to protect innocent third parties.

Plunkett Centre for Ethics in Healthcare, St Vincent's Hospital, Darlinghurst, NSW.

Bernadette M Tobin, MA PhD, Director.

Faculty of Medicine, University of Sydney, NSW.

Steven R Leeder, PhD FRACP FFPHM, Dean.

Epilepsy Unit and Department of Neurology, Westmead Hospital, Westmead, NSW.

Ernest R Somerville, MB BS FRACP FRCP, Neurologist.