The information minefield: access to clinical information: review article

Abstract

A crucial element of any fiduciary relationship is the maintenance of confidentiality. While the obligation to keep detailed records remains, the South African Constitution and legislation have eroded the clinician's ability to absolutely safeguard their patients' privacy. Clinicians cannot guarantee absolute confidentiality and should always warn patients of the limits of privilege in their relationship (especially in forensic settings). A bewildering array of interested parties may now petition for access to clinical information, and it is not always clear under which circumstances legislation demands disclosure, and when ethical considerations prevent it. It is therefore encumbent on practitioners to understand when disclosure is sanctioned, and when the demands of legislation cannot be resisted.


South African Psychiatry Review Vol.7(1) 2004: 19-20, 23-26