Limits for confidentiality of information on the health status of a patient

Paciento sveikatos informacijos konfidencialumo užtikrinimas yra viena iš problemų, su kuria praktikoje dažnai susiduria asmens sveikatos priežiūros specialistai ir bioteisės srities mokslininkai. Nors teisės doktrinoje, teisės aktuose ir teismų praktikoje pripažįstama, kad konfidencialumo principas nėra absoliutus ir gali būti ribojamas dėl visuomenės saugumo, nusikalstamumo prevencijos, visuomenės sveikatos arba kitų žmonių teisių ir laisvių apsaugos, faktinių konfidencialumo ribojimo pagrindų turinys ne visuomet aiškus. Straipsnyje remiantis teisės aktais, Europos Žmogaus Teisių Teismo praktika, teisės doktrina analizuojami vieni iš paciento sveikatos informacijos konfidencialumą galimai ribojančių faktinių pagrindų: grėsmė kito asmens sveikatai ar gyvybei, užkrečiamųjų ligų kontrolė, moksliniai tyrimai.Ensuring a confidentiality of information on the health status of a patient is one of the most frequent problems met by person’s health care professionals and scientists in their practice. From the times of Hippocrates, a confidentiality of information on the health status of a patient is traditionally a part of medical deontology. However, it is recognized that the principle of confidentiality is not absolute, and it can be limited according to the exception provided in the Article 8 Part 2 of the European Convention for Protection of Human Rights and Fundamental Freedoms when such limitation is required by the interests bound with state security, public order or national economic welfare in democratic society striving to prevent violations of law or crimes, also to protect health or moral of the population as well rights and freedoms of other persons; however, the contents of the factual reasons for limitation of confidentiality is not always clear. So, upon existence of certain legal and factual reasons, the principle of confidentiality of information on the health status of a patient can be limited; however, frequent misusing of power by subjects (employers, insurance companies and so on) or ordinary carelessness of data managers or lack of enlightenment (qualification) of doctors and patients cause a conflict of interests of an individual, a doctor and the public in the sphere of health care services. In the paper, on the base of the relevant legal norms as well as practice of the European Human Rights Court and the doctrine, the factual reasons possibly usable for limiting confidentiality of information on the health status of a patient are analyzed; they include a danger for health or life of another person, control of contagious diseases, and scientific research. The analysis of the said reasons enabled the author to state that confidentiality of information on the health status of a patient is not only ethical but also legal principle encouraging a confidence between the health care professional and the patient; however, it can be limited when it is necessary to ensure public safety, public health or protection of rights and freedoms of other persons. In addition, after elucidation of the legal regulation of control of contagious diseases, the author concluded that if a danger for health or life (physical damage) of a person associated with the patient appears because of the health status of the patient, the health care professional upon taking into account the equilibrium of interests and the possible negative consequences, should immediately inform the responsible state institutions and the person associated with the patient on the menacing physical damage. In addition, the author points out that promotion of scientific progress and public welfare would be a sufficient reason for limitation of confidentiality of information on the health status of a patient for public benefit, so it is necessary to change the complicated and long administrative procedure of issue of permission for planned scientific research where information on the health status of a patient should be used only