Medicolegal: Patient Confidentiality« Back to Questions List

Case of the NUH Psychiatrist
Posted by Admin
Asked on 03/12/2019 1:33 pm

In the recent case, ($50K fine) the issues surrounding Patient Confidentiality is not about ”who the guity or wrongdoer” is. The concept of Patient Confidentiality is about the ownership of information & patient autonomy.
While it appears harsh that the SMC has imposed a hefty penalty on a medical practitioner who apparently breached through ”oversight”, it could suggest that the switch from paternalism to patient autonomy remains in transition.
Much more work too is required in dissemination of information of the concept through education. Difficulty lies in the change in mindset. Doctors have been less incline to refer & there is no obligation to pass on information to the next treating physician through an integrated mechanism of collation of patient data. Thus, dissemination of patient information remains at risks of falling into wrong hands simply because safeguards in procedure & regulations are not yet well defined.
Lots of work yet to be done in what is the correct procedure for dissemination of information & the regulatory framework to protect such, in many ways, un-intended mistakes must take priority.
Patients are now educated. They understand their fundamental rights. Patients are also better informed & are more prepared to make a stand should something is a miss in either treatment or any other aspects of their medical care.

Posted by Admin
Answered On 03/18/2019 5:24 pm

Issues of Patient Confidentiality, consent, patient autonomy are some of the changes that medical practitioners have to grapple with from the long held sacred cow of paternalism. Paternalism being ingrained is hard to slay for there is often a need for a drastic mindset change in order to give up what is essentially held in the highest esteem.
This current case highlights how easily it is to fall foul & while the concept is not yet fully developed, is unfortunate that cases like this will continue to make headlines.
Patient confidentiality issues are also difficult within a system whereby there is no one collation system for medical data. Patients, especially - seniors & elderly in Singapore - are now presenting with complex issues which often requires multidisciplinary care. The role of each player now needs to be defined before any information can be disclosed. How much or to whom should any information be disclosed will be a nightmare to navigate. There will be more of these cases as it is not only patient confidentiality issues to content with but also, consent issues, disclosure issues etc all will be upcoming as patient autonomy becomes better implemented within the health care system.

Posted by admin
Answered On 03/12/2019 5:57 pm