Professional Secrecy OR Professional Confidentiality Dr Rubina Salma

Professional Secrecy OR Professional Confidentiality Dr. Rubina Salma Yasmin MBBS, MCPS, M. Phil (Forensic Medicine)

Professional Secrecy A professional secret is one which a doctor comes to know during his doctor-patient Relationship. Medical information about patient is confidential and should be kept in safe areas of the hospital under direct control and supervision of the medical practitioners away from public.

Professional Secrecy Duty of R. M. P. to protect confidentiality of patients secrets. This is an ethical and legal duty of a doctor. Disclosure of patient’s secrets can lead to legal action against the medical practitioner.

Confidentiality The state of keeping or being kept secret or private. A set of rules that limits access or places restrictions on certain types of information. It means keeping a client’s information between you and the client and not telling others.

Medical Confidentiality Non disclosure of the private information of another. A substantive rule in Bioethics saying that the information a patient reveals to a health care provider is private and has limits on how and when it can be disclosed to a third party, usually the provider must obtain permission from the patient to make such a disclosure

Medical Confidentiality It is the principle which protects the right of patients to expect that details of their medical conditions should be divulged only to those who need to know them for medical purposes. Confidentiality is an essential part of any clinical relationship.

Medical Confidentiality When clients (patients) enters into a health-care relationship they relinquish some personal privacy in permitting physical examination, take tests or giving social and medical histories. In general all personal medical information is confidential unless the client (patients) requests disclosure to third parties or a specific exception permits or requires disclosure

Medical Confidentiality The issue of confidentiality dates back to the Hippocrates oath for doctors, which prescribes “What I may see or hear in the course of treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about”

Rationale of Confidentiality A patient provides many important personal and other information to health care providers. The information disclosed by a patient to a physician during the course of relationship is under an implied trust that it will be kept confidential to the greatest possible degree.

Rationale of Confidentiality Any breach of this trust will seriously affect the patient’s attitude in providing further information to the doctor which might be necessary for making correct diagnosis and planning appropriate management. Thus it may adversely affect the patient care.

Rationale of Confidentiality It is important that the patient feels free to disclose any information to the physician. This will facilitate the physician to provide most appropriate care to the patient. It is only possible when the patient has full confidence in the caring physician that he will keep the patient information and secrets confidential

Professional Secrecy Confidentiality-Hippocratic oath Any information received by a medical practitioner during the doctor-patient relationship is a sacred trust with the doctor. Part of the Hippocratic oath is that the medical practitioner will not divulge secrets of the patient. However this duty is not absolute as doctor may divulge secrets in the interest of the public.

Professional Secrecy Privilege communication- disclosure of patients information to agencies or persons who qualify to receive it having an interest in it or in reference to which the doctor has a duty to disclose. It is considered justified in the eyes of law provided it is made in good faith during legal or social duty.

Professional Secrecy v Disclosure of professional secret( as a privileged communication) is justified in the following circumstances: q As a Statutory duty to the State: State § Notifications of birth, death or diseases like industrial, contagious or infectious. § Notification of cases of food poisoning from a restaurant, or contamination of public drinking water, also notification of homicidal poisoning cases to the police.

Professional Secrecy q Disclosure in courts- § A doctor must disclose the patient secrets when a judge so rules. § In such a situation, the information can be written on a piece of paper and handed over to the judge. § Refusal to disclose may result in contempt of court

Professional Secrecy q As a moral duty: § Under this heading the disclosure is justified in the following circumstances; § A person who develops open tuberculosis or is a typhoid carrier, is not fit to work as a hotel waiter or serves drinks to the public. § An engine driver who is color blind or epileptic is not fit for this job.

Professional Secrecy A person suffering from a communicable disease should be prohibited from entering a swimming pool. Doctors have ethical and legal responsibility to warn partners of patients with the AIDS virus. Doctors have legal as well as ethical responsibility to report all cases of suspected child abuse and to protect the child from further harm.

Professional Secrecy q Responsibility in criminal cases; If a medical practitioner is called to treat a patient who is a victim or accused of a serious crime, e. g. murder, robbery, etc, he should inform the proper authorities.

Professional Secrecy In certain important situation of everyday life, For example, when a servant is sent by a master for medical examination or when a report is required from the doctor in connection with insurance cases, the privileged communication is made in good faith to the authorities entitled to receive it.

Systems of Medical Practice Dr. Rubina Salma Yasmin MBBS, MCPS, M. Phil (Forensic Medicine)

Systems of Medical Practice 1. Allopathic System 2. Homeopathic System 3. Tibb/Hikmat 4. Ayurvedic System

Systems of Medical Practice Allopathic System: It is the most authentic system of medical practice. This system is based on scientific principles. There is continuous scientific research going on in this system It is the modern system and recognized all over the world.

Systems of Medical Practice Medical colleges and medical universities are the teaching facilities of this system. MBBS – F. Sc 1 st class + 5 years in medical college & one year House Job in a Teaching hospital. BDS – F. Sc 1 st class + 4 years in a dental college & one year House Job.

STATUTE LAWS OF MEDICAL PRACTICE The medical practice is regulated by various statute laws.

STATUTE LAWS OF MEDICAL PRACTICE Medical and dental degree Ordinance 1980 Allopathic system (Prevention of misuse act- 1962) PMDC Ordinance 1962 Drug Act 1976 Dangerous drug Act 1930 Provincial laws e. g. HRA (Health Regulatory Authority)

STATUTE LAWS OF MEDICAL PRACTICE Drug Act 1976: This act is concerned with registration of drugs produced locally or imported and marketed This act has modernized the drug legislations in accordance with the recommendations of World Health Organization.

STATUTE LAWS OF MEDICAL PRACTICE Specific objectives of Drug Act 1976: Marketed drugs whether produced locally or imported are of required quality. New drugs are adequately tested and evaluated for both safety and efficacy before their intended use. Medical practitioners are kept fully informed about the properties of the drugs i. e. their desired and undesired effects.

STATUTE LAWS OF MEDICAL PRACTICE Term of approval of any product can be modified or the product can be withdrawn from use after marketing on the bases of additional information. There is also control over advertising to prevent or discourage misuse by medical profession and public.

STATUTE LAWS OF MEDICAL PRACTICE Some of the sections of the act are concerned with the a. Constitution of Central Licensing Board b. Constitution of Registration Board c. Standing Drugs Committees

STATUTE LAWS OF MEDICAL PRACTICE Dangerous Drug Act 1930: This act deals with misuse of drugs having potential for abuse (addiction). Abuse of drug means that drug is taken apart from its medicinal use. Dangerous drugs are drugs of addiction. These are prescribed only when needed.

STATUTE LAWS OF MEDICAL PRACTICE Drugs having potential for misuse: Main groups which are misused and require stricter control are Coca, Opiates and Amphetamines. Drug addiction or drug dependence.

STATUTE LAWS OF MEDICAL PRACTICE Strategic measures to prevent abuse of dangerous drugs: Punishing severely those who indulge in illegal transportation of such drugs. (Recent amendments in Dangerous Drug Rules have prescribed severe punishment like death penalty). Providing treatment centers. Restricting availability of such drugs to those who are predisposed to their abuse.

STATUTE LAWS OF MEDICAL PRACTICE Addiction of any kind is “haram” in Islam. Faith in Allah and obedience to His commands in this respect is the best hope.

STATUTE LAWS OF MEDICAL PRACTICE Medical And Dental Degree Ordinance 1980: - Defining scientific medical and dental systems identifying authorities having right of conferment of medical degree / diploma. - Prohibiting unauthorized conferment of medical degrees and diplomas and falsely assuming or using medical or dental title.

STATUTE LAWS OF MEDICAL PRACTICE Scientific medical and dental system in law means a Allopathic system which includes medicine, surgery, obstetrics/ gynecology and dentistry. Only universities can grant degrees/diplomas. Universities which are established by act of legislature. Provincial or federal universities and CPSP.

STATUTE LAWS OF MEDICAL PRACTICE Allopathic system (Prevention of misuse act 1962) -It defines RMP, (Registered with PMDC). -It prevents misuse of allopathic system.

STATUTE LAWS OF MEDICAL PRACTICE Use of word Doctor (The title Dr. can only be used by a medical practitioner duly registered with PM&DC. -False degrees/diplomas of allopathic system. Performing surgical procedures except injections/incision of boils. Prescribing any dangerous drug specified in the rules.

STATUTE LAWS OF MEDICAL PRACTICE Proceedings for contravention of the act is initiated by drug inspector (drug act 1940) - Court – Magistrate 1 st class. - Punishment 1 year imprisonment or fine of Rs. 2000/- or both.