Thu, Dec 16, 2010 - Page 8 News List

On medical ethics and the privacy of patients

By Andrew Huang 黃達夫

The concept of protecting the privacy of patients has long been lacking in Taiwan’s medical circles. Although this concept has been promoted over the past few years, many medical experts still do not fully understand it, not to mention the general public.

Take the shooting of Chinese Nationalist Party (KMT) Central Standing Committee member Sean Lien (連勝文), for example. The confusion surrounding the incident has once again blurred the definitions of “medical record” and “patient privacy.” I was a bit surprised to hear a reporter ask whether Lien’s medical records should be released, because in my mind, they had already been released — albeit in a manner that was vague, incomplete and failing to meet professional standards.

The medical status of public figures involved in a major social event should certainly be released. The fact is that when the spokeswoman of National Taiwan University Hospital briefed the press on Lien’s injury on the evening of the shooting, that constituted a public release of crucial parts of Lien’s medical records.

Since the hospital had been authorized to report Lien’s condition to the public soon after the shooting occurred, they should have been careful to describe his injuries in such a way that no misunderstanding could result. This is the most basic requirement for medical professionalism.

In other words, because medicine is a specialized field, we must authorize medical experts to report on a patient’s condition. They should adhere to their expertise and give a precise account of a patient’s condition in order to gain the public’s trust.

How could Tsai Fu-chang (蔡甫昌), associate professor and chairman of the hospital’s Department of Social Medicine, claim in an editorial that the lack of precision in the hospital’s report on Lien’s condition was unrelated to the case? Doesn’t that view confirm that Taiwan’s medical community does not think that the quality of medical records is important?

It is incorrect to limit the term “medical record” to mean only papers, electronic files, X-ray film and examination reports. For example, if a medical worker unintentionally mentions to his family after work that somebody saw a doctor today, he would be violating patient privacy by disclosing medical records.

Here’s another example: We often see hospital staff holding press conferences for TV reporters. Accompanied by hospital superintendents, chief surgeons and the physicians in charge, patients — perhaps following an operation in which a father has donated part of his liver to his son — lift their clothes to reveal the scars to the media to prove how successful the surgery was.

On the surface, it might seem that the patient has given their authorization, but the fact is that they often feel obliged to cooperate out of respect for the doctor. Such behavior is also a violation of the spirit of patient privacy protection. Whether medical professionalism or medical ethics, implementing this spirit is key.

Andrew Huang is president of the Koo Foundation Sun Yat-sen Cancer Center.

TRANSLATED BY EDDY CHANG

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