Hippocratic Oath and Confidentiality in medical ethics

1. School of Medical and Allied Sciences
Course Code: BMLS1005 Course Name: Medical Law & Ethics
Faculty Name: A. Vamsi Kumar Program Name: B.Sc. MLT
UNIT -1
Topic
Hippocratic oath & Confidentiality in
medical ethics

2. Sem – 1 Course overview
Sl. No
Course Code Name of the Course
Faculty Name
1 BMLS1001 Introduction to National Healthcare Delivery System in India D. Srinivasa Rao
2 BMLS1002 BASic computers and information Science
Ms. Heena Kharna
3 BLLUCT1001 Professional Communication –1 Priyanka
4 BMLS1004 Medical Terminology, Record keeping A. Sankar
5 BMLS1005 Medical Law and Ethics A. Vamsi Kumar
6 BMLS1006 Introduction to Quality and Patient safety A. Vamsi Kumar
7 BMLS1007 Professionalism and values A. Vamsi Kumar
8 BMLS1009
Principals of Management with special reference to Medical Laboratory
Science (MLS) management D. Srinivasa Rao
9 BMLS1010 Community orientation and clinical visit D. Srinivasa Rao
10 BMLS1051 BASic computers and information Science – Practical Ms. Heena Kharna
11 BMLS1053 Medical Terminology, Record keeping - practical A. Sankar
12 BMLS1054 Introduction to Quality and Patient safety - practical A. Vamsi Kumar
13 BMLS1056
Principals of Management with special reference to Medical Laboratory
Science (MLS) management-Practical P. Yashwanth
14 BLEUCT1002 Creative / Liberal Arts Mr Santanu Mukerji
15 BCEUCT1002 WASte Management Dr. Shafat Ahmad Khan

3. Syllabus Overview
Unit 1
Medical ethics, Code of conduct Definition & Basic principles of medical
ethics
Number of
Lecture Hours
6
Medical ethics - Definition - Goal - Scope, Introduction to Code of conduct, Basic principles of medical
ethics – Confidentiality
Unit 2
Malpractice and negligence, Autonomy and informed consent & Care of
the terminally ill-
Number
of Lecture
Hours
6
Malpractice and negligence - Rational and irrational drug therapy, Autonomy and informed consent -
Right of patients, Care of the terminally ill- Euthanasia
Unit 3
Organ transplantation & Medico legal aspects of medical records Number
of Lecture
Hours
6
Organ transplantation, Medico legal aspects of medical records – Medico legal case and type- Records
and document related to MLC - ownership of medical records - Confidentiality Privilege communication
- Release of medical information - Unauthorized disclosure - retention of medical records - other
various aspects.
Unit 4
Professional Indemnity insurance policy Number of Lecture Hours 6
Development of standardized protocol to avoid near miss or sentinel events
Unit 5 Obtaining an informed consent. Number of Lecture Hours 6
Ethics in the profession of Medical Laboratory Science

4. Text Books
1 Apply their knowledge on medical ethics
2 Explain Organ transplantation & Medico legal aspects of medical records
3 Explain Organ transplantation & Medico legal aspects of medical records
4
5
Reference Textbooks

5. Prerequisite/Recaptulations

6. Course Outcomes
Course
Outcomes
At the end of the course student will be able to,
1
Define Medical ethics, Code of conduct Definition & Basic principles of
medical ethics
K1
2
Outline what is Malpractice and negligence, Autonomy and informed consent
& Care of the terminally ill
K2
3 Explain Organ transplantation & Medico legal aspects of medical records K2
4 Build Professional Indemnity insurance policy K3
5 Make use of Obtaining an informed consent K3

7. Course Objectives
Course
Objectives
1 Outline Personal values & Attitude and behavior
2 Make use of Code of conduct
3 Identify Importance of team efforts

10. Hippocratic Oath

11. Introduction

19. Summary of Hippocratic Oath

20. Confidentiality in medical ethics

22. Confidentiality is one of the core and fundamental tenets
at medical practice. It requires health care providers to
maintain a patient’s personal health information private
unless consent to release the information is provided by
the patient.
It was established in Hippocratic Oath (5th BC).
Confidentiality provides a foundation for trust in the
physician-patient relationship.
Physicians are obliged to keep all of the information about
their patients confidential.
WHAT DOES THE DUTY OF CONFIDENTIALITY
REQUIRE?

23. THE CORE OF THE CONFIDENTIALITY IS BASED ON:
 Respect the patient privacy – the patient expect doctors
to maintain confidentiality
 Confidentiality promotes trust in physician-patient
relationship
 Confidentiality heartens patients to seek medical
attention
 Confidentiality encourages patients to share information
that can be important for the decision on the treatment
 Prevention of harmful consequences to patients –
discrimination based on ill health

24. WHAT INFORMATION IS CONFIDENTIAL?
All identifiable patient information, whether written,
computerised, visually or audio recorded is subject to the
duty of confidentiality. It covers:
 any clinical information about an individual’s diagnosis
or treatment
 a picture, photograph, video, audiotape or other images
 who the patient’s doctor is and what clinics patients
attend and when
 shared medical information at conferences
 all facts that have been found out during the
consultation and investigations
 all the information about the patient that the physician
has learned while practicing his profession

25. WHAT DOES THE DUTY OF CONFIDENTIALITY REQUIRE? THE
COMPUTER IN OUR DAILY WORK.
Electronic medical records can pose new and unique challenges
to confidentiality. In accordance with the Health Information
Portability and Accountability Act of 1997 (HIPAA),
institutions are required to have policies to protect the privacy of
patients’ electronic information, including procedures for
computer access and security.

26. VIOLATION OF CONFIDENTIALITY. LEVELS
Unauthorised release of confidential information, disclosure of
confidential information
Levels of breaching confidentiality:
0 – no breach of confidentiality:
between the members of the medical team or required by law
1 – trivial breach of confidentiality:
the information is shared to third person without names
2 – significant breach of confidentiality:
medical information is discussed with non-medical person and
identifies the patient; damages to the patients could follow
3 – severe breach of confidentiality:
shared with non-medical; patient is identified and too much
compromised in the society

27. WHEN CAN CONFIDENTIALITY BE BREACHED?
Overriding concerns can lead to the need to breach confidentiality in
certain circumstances.
Exception 1: Concern for the safety of other specific persons
Examples:
 homicidal ideation, when the patient shares a specific plan with a
physician;
 psychotherapist to harm a particular individual;
 the man, just tested positive for HIV…

28. WHEN CAN CONFIDENTIALITY BE BREACHED?
In many countries State Law requires the report of certain
communicable/infectious diseases to the public health authorities. That’s
why, the duty to protect public health outweighs the duty to maintain a
patient's confidence.
Exception 2: Legal requirements to report certain conditions or
circumstances
Examples:
 measles, rabies, anthrax, botulism;
 sexually transmitted diseases, and tuberculosis;
 suspected cases of child, dependent adult, and elder abuse are
reportable;
 gunshot wounds.

29. WHAT IF A FAMILY MEMBER ASKS HOW THE
PATIENT IS DOING?
If there is not explicit permission from the patient to share
information with family member, it is generally not
ethically justifiable to do so. Except in cases where the
spouse is at specific risk of harm directly related to the
diagnosis, it remains the patient's rather than the
physician's, obligation to inform the spouse.

30. References
https://hslmcmaster.libguides.com/c.php?g=306726&p=2044095

31. YouTube videos
1. https://www.youtube.com/watch?v=hAe4yIlDwI4&t=14s
2. https://www.youtube.com/watch?v=ssOEJpBQErc