Razis D V
Hygia Hospital, Athens, Greece.
Qual Assur Health Care. 1990;2(3-4):353-7. doi: 10.1093/intqhc/2.3-4.353.
The Hippocratic definition of Confidentiality, i.e. the absolute and without any exceptions observation of secrecy by the physicians, expresses the Hippocratic philosophy in Medicine. Hippocratic Medicine is completely individualized--the physician's sole responsibility is the patient's well being. Confidentiality undoubtedly strengthens the trust in the patient-physician relationship and mutual trust is indispensable for both diagnostic work-up and therapeutic applications. Exceptions to confidentiality might be required in order to protect the society from infectious communicable disease, from dangerous patients and for the scientific progress. However, it is not easy at all to decide for exceptions to confidentiality. The profound changes of the human societies in the end of the 20th century, the fantastic progress in Medicine and Science and the completely different approach to the delivery of medical services in modern times, make necessary the re-evaluation of medical deontology and medical confidentiality.
希波克拉底对保密的定义,即医生必须绝对且毫无例外地保守秘密,体现了医学中的希波克拉底哲学。希波克拉底医学是完全个体化的——医生的唯一责任是患者的福祉。保密无疑增强了医患关系中的信任,而相互信任对于诊断检查和治疗应用而言都是不可或缺的。为了保护社会免受传染病、危险患者的侵害以及推动科学进步,可能需要对保密进行例外处理。然而,决定保密的例外情况绝非易事。20世纪末人类社会的深刻变革、医学和科学的惊人进步以及现代医疗服务提供方式的截然不同,使得重新评估医学道义学和医疗保密变得必要。