Larkin G L, Moskop J, Sanders A, Derse A
Ann Emerg Med. 1994 Dec;24(6):1161-7. doi: 10.1016/s0196-0644(94)70249-7.
Confidentiality is a promise rooted in tradition, law, and medical ethics. Emergency physicians treat a variety of patients to whom confidentiality is of vital importance: employees, celebrities, victims of violence or disaster, minors, students, criminals, drug abusers, and patients with STDs. EDs should develop methods of ensuring confidentiality for all patients. Although confidentiality is an important principle that should be respected and guarded, it is not absolute. Various laws mandate disclosure of certain patient information; in addition, an overriding moral duty may occasionally require a breach of confidentiality. As Beauchamp and Childress noted, "the therapeutic role may sometimes have to yield to one's role as citizen and as protector of the interests of others." In general, however, circumstances requiring a breach of confidentiality are rare.
保密性是一项植根于传统、法律和医学伦理的承诺。急诊医生会治疗各种各样的患者,对他们而言保密性至关重要:员工、名人、暴力或灾难受害者、未成年人、学生、罪犯、药物滥用者以及性传播疾病患者。急诊科应制定确保所有患者信息保密的方法。尽管保密性是一项应得到尊重和保护的重要原则,但它并非绝对的。各种法律规定某些患者信息必须披露;此外,压倒一切的道德责任有时可能要求违背保密原则。正如博尚和奇尔德雷斯所指出的,“治疗角色有时可能不得不让位于作为公民以及他人利益保护者的角色”。然而,一般来说,需要违背保密原则的情况很少见。