Milanifar Alireza, Larijani Bagher, Paykarzadeh Parvaneh, Ashtari Golanna, Mehdi Akhondi Mohammad
Medical Ethics PhD Candidate, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Med Ethics Hist Med. 2014 Aug 6;7:13. eCollection 2014.
Medical ethics is a realm where four important subjects of philosophy, medicine, theology and law are covered. Physicians and philosophers cooperation in this area will have great efficiency in the respective ethical rules formation. In addition to respect the autonomy of the patient, physician's obligation is to ensure that the medical intervention has benefit for the patient and the harm is minimal. There is an obvious conflict between duty of confidentiality and duty of mandatory reporting. Professional confidentiality is one of the basic components in building a constant physician-patient relationship which nowadays, beside the novelty, it is the subject of discussion. Legal obligation of confidentiality is not absolute. In physician-patient relationship, keeping patient's secrets and maintaining confidentiality is a legal and ethical duty, and disclosure of such secrets is mainly through specific statutes. Thus, there are a number of situations where breach of confidentiality is permitted in different legal systems. One of the situations where breaching confidentiality is permitted is the medical mandatory reporting to the relevant authority which is in accordance with many countries' legal systems. Some situations are considered in many countries legal systems' such as notification of births and deaths, infectious diseases, child abuse, sport and relevant events, medical errors, drug side effects and dangerous pregnancies. In this paper, we will examine and discuss medical mandatory reporting and its ethical and legal aspects in the judicial and legal system of Iran and few other countries. Finally we will suggest making Medical Mandatory Reporting Law in Iran.
医学伦理学是一个涵盖哲学、医学、神学和法律这四个重要学科的领域。医生和哲学家在这一领域的合作将在各自伦理规则的形成方面产生巨大成效。除了尊重患者的自主权外,医生的义务是确保医疗干预对患者有益且危害最小。保密义务和强制报告义务之间存在明显冲突。专业保密是建立持续医患关系的基本要素之一,如今,除了新颖性之外,它也是讨论的主题。保密的法律义务并非绝对。在医患关系中,保守患者秘密和保持保密是一项法律和伦理义务,此类秘密的披露主要通过特定法规进行。因此,在不同的法律体系中,存在一些允许违反保密规定的情况。允许违反保密规定的情况之一是根据许多国家的法律体系向相关当局进行医疗强制报告。许多国家的法律体系会考虑一些情况,如出生和死亡通知、传染病、虐待儿童、体育及相关赛事、医疗差错、药物副作用和危险妊娠等。在本文中,我们将研究和讨论伊朗及其他一些国家司法和法律体系中的医疗强制报告及其伦理和法律方面。最后,我们将建议伊朗制定《医疗强制报告法》。