Sankar Pamela, Mora Susan, Merz Jon F, Jones Nora L
Center for Bioethics, University of Pennsylvania, Philadelphia, PA 19104-3308, USA.
J Gen Intern Med. 2003 Aug;18(8):659-69. doi: 10.1046/j.1525-1497.2003.20823.x.
To lay the groundwork for a better understanding of patient views on medical confidentiality.
Studies were found by searching medline, bioethicsline, and selected bibliographies. Articles concerning physician perspectives or implications of legal and administrative regulations were excluded. Only peer-reviewed journal articles reporting original research on patients' confidentiality views and conduct were included.
Many patients are unaware of or misunderstand their legal or ethical right to medical confidentiality protections, which leads them to both over- and underestimate confidentiality protections. The possibility that medical information might be revealed, intentionally or not, to acquaintances in a clinic or other social community troubles patients as much as information release to insurers or employers. A significant minority of patients distrust confidentiality protections, leading some to report that they delay or forgo medical care. If doubtful that confidentiality will be upheld, patients will act independently to protect information.
Our review found a wider variety of understandings and beliefs about medical confidentiality among patients than are often indicated in the writings of practitioners or legal experts. As medical confidentiality regulations evolve, these differences need to be recognized and accounted for in interactions between practitioners and patients.
为更好地理解患者对医疗保密的看法奠定基础。
通过检索医学文献数据库（Medline）、生物伦理学数据库（Bioethicsline）以及选定的参考文献找到相关研究。排除了涉及医生观点或法律及行政法规影响的文章。仅纳入了报道关于患者保密观点及行为的原创研究的同行评审期刊文章。
许多患者未意识到或误解了他们在医疗保密保护方面的法律或道德权利，这导致他们对保密保护的程度既高估又低估。医疗信息可能有意或无意地透露给诊所或其他社交圈子中的熟人，这与信息透露给保险公司或雇主一样令患者困扰。相当一部分患者不信任保密保护措施，导致一些人表示他们会推迟或放弃医疗护理。如果怀疑保密措施无法得到遵守，患者会自行采取行动保护信息。
我们的综述发现，患者对医疗保密的理解和信念比从业者或法律专家的著作中通常所指出的更为多样。随着医疗保密规定的不断演变，在从业者与患者的互动中需要认识到并考虑这些差异。
