Higgins Gerald L
Can Fam Physician. 1988 Jun;34:1301-6.
The author of this paper examines physicians' regard for the confidentiality of medical information in the light of their perception of their own role. Five case studies of increasing complexity of medical management and ethical issues, derived from practice and accompanied by questions relating to confidentiality and medical management, were submitted to randomly selected family physicians in Alberta. Analysis of the replies to determine attitudes to confidentiality and how the respondents perceived patients' best interests, and statements of how they would act in certain situations, disclosed that a substantial minority of the physicians were still prepared to breach confidentiality and exercise Hippocratic professional judgement in certain situations. The bases of confidentiality of medical information are reviewed, together with changing modes of medical ethics and the increasing trend to rights derived from patients, autonomy, and the ways in which these factors may affect the physician-patient relationship.
本文作者根据医生对自身角色的认知,审视了他们对医疗信息保密性的重视程度。从实际案例中选取了五个医疗管理复杂性和伦理问题不断增加的案例研究,并附上与保密性和医疗管理相关的问题,提交给艾伯塔省随机挑选的家庭医生。通过分析回复以确定对保密性的态度、受访者如何看待患者的最大利益,以及他们在某些情况下会如何行动的陈述,发现相当一部分医生在某些情况下仍准备违反保密性并行使希波克拉底式的专业判断。本文回顾了医疗信息保密的基础,以及不断变化的医学伦理模式和源自患者自主权的权利增加趋势,以及这些因素可能影响医患关系的方式。