Medical secrecy: the rights and responsibilities of participants of the medical process

N. Lisnevska
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Abstract

Background. Medical secrecy (MS) is a set of information about the disease, its treatment, the results of examinations, which became known to certain healthcare workers (HCW) during their professional activities. The attending physician and the nurse who performs the drug administration are most aware of the patient’s condition. The information included in the MS is divided into two types: medical and personal information of the patient, which became known during the performance of medical professional duties. Objective. To describe selected aspects of the MS problem. Materials and methods. Analysis of the legal framework. Results and discussion. Medical information belongs to professional confidential information and should not be disclosed. Even the information about the very fact of seeking medical care belongs to professional confidential information. Unlawful intentional disclosure of MS by a person to whom it became known in the course of its professional duties entails criminal liability. This applies not only to HCW, but also to other staff of medical institutions. It is possible to provide information about the treatment and even the patient’s stay in the hospital to third parties, including relatives of any degree of kinship, only with the patient’s own consent. Exceptions include cases of extreme urgency, such as when a patient is taken to hospital unconscious and relatives can provide information on existing allergies and comorbidities. Of course, in such cases, the necessary disclosure limits should be followed. If a relative or other person wishes to visit a patient in the hospital, he or she should be contacted in person and visited only with personal consent. With regard to law enforcement officers, the answer to the question of whether a particular patient is treated in this institution should be given only in the presence of criminal proceedings and after resolving this issue with the chief physician. It should be noted that medical information concerning the deceased is also confidential and cannot be disclosed. It should not be assumed that the deceased can no longer be harmed, so any liability will be absent. Disclosure of such information is also a crime, on the basis of which criminal proceedings may be started. Recently, the medical legislation in Ukraine was changed, and as of today, the fine for disclosing MT is over UAH 50,000. When treating patients with disabilities, all necessary information should be provided to their parents or carers. When treating children aged 14-18, it is impossible not to provide information about treatment to parents, although this may be contrary to the wishes of the child. An important issue is the provision of information to children who are incapacitated by age, but legally capable. If a 5-year-old child asks questions about his or her health, a doctor or other HCW must answer them in a form that is accessible. A similar situation occurs with mentally ill patients: they are deprived of legal capacity, but they have the right to know about their health. You should also be very careful in keeping medical records. For example, information on viral infections (hepatitis, HIV/AIDS) should not be placed on the cover of the medical history, but inside. Conclusions. 1. MS information is divided into two types: medical and personal information of the patient. 2. Medical information belongs to professional confidential information and should not be disclosed. 3. It is possible to provide information about the treatment and even the patient’s stay in the hospital to third parties, including relatives, only with the patient’s own consent. 4. In the treatment of patients with disabilities, all necessary information should be provided to the parents or carers.
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医疗保密:医疗过程参与者的权利和责任
背景。医疗保密(MS)是一组关于疾病、治疗、检查结果的信息,这些信息是某些保健工作者(HCW)在其专业活动中知道的。主治医生和给药的护士最了解病人的病情。MS中包含的信息分为两类:患者的医疗信息和个人信息,这些信息是在履行医疗专业职责过程中获知的。目标。描述MS问题的某些方面。材料和方法。法律框架分析。结果和讨论。医疗信息属于专业保密信息,不得外泄。甚至有关求医的信息本身也属于专业机密信息。在履行专业职责过程中知悉MS的人士非法故意披露MS,须负刑事责任。这不仅适用于医务人员,也适用于医疗机构的其他工作人员。只有在患者本人同意的情况下,才可以向第三方,包括任何程度的亲属提供有关治疗甚至患者住院情况的信息。例外情况包括极端紧急的情况,例如当患者被送往医院时失去意识,亲属可以提供有关现有过敏和合并症的信息。当然,在这种情况下,应遵守必要的披露限制。如果亲属或其他人希望在医院探望病人,应亲自与他或她联系,并在征得本人同意的情况下探视。关于执法人员,对于某一特定病人是否在该机构接受治疗的问题,只有在有刑事诉讼的情况下,并在与主任医生解决这一问题之后,才能给出答案。应当指出,有关死者的医疗资料也是保密的,不能透露。不应假定死者不再受到伤害,因此将不存在任何责任。披露这类信息也是一种犯罪,可据此提起刑事诉讼。最近,乌克兰的医疗立法发生了变化,截至今天,披露MT的罚款超过UAH 50,000。在治疗残疾患者时,应向其父母或照顾者提供所有必要的信息。在治疗14-18岁的儿童时,不可能不向父母提供有关治疗的信息,尽管这可能与儿童的意愿相反。一个重要的问题是向因年龄而丧失行为能力但在法律上有能力的儿童提供信息。如果5岁儿童询问有关其健康的问题,医生或其他卫生工作者必须以易于获取的形式回答。精神病人也有类似的情况:他们被剥夺了法律行为能力,但他们有权了解自己的健康状况。你也应该非常小心地保存医疗记录。例如,关于病毒感染(肝炎、艾滋病毒/艾滋病)的信息不应该放在病史的封面上,而应该放在里面。结论:1。MS信息分为两类:患者的医疗信息和个人信息。2. 医疗信息属于专业保密信息,不得外泄。3.只有在患者本人同意的情况下,才可以向包括亲属在内的第三方提供有关治疗甚至患者住院情况的信息。4. 在治疗残疾病人时,应向其父母或照顾者提供所有必要的信息。
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