Confidentiality and responsible publication
Publishing patient information raises questions of consent and identification. A name is only one way a patient may be recognised, and professional access to information carries confidentiality obligations.
Confidential information and consent
Confidentiality applies both to patients whose clinical histories are used in medical writing and to medical staff who supply information. UK General Medical Council guidance quoted in 2007 treated information acquired by a doctor professionally as confidential even when it was also in the public domain.
That guidance advised obtaining explicit patient consent whenever possible before discussing care, whether or not names or other identifying information would be revealed, and required explicit consent where the disclosed details would identify patients. It also advised acting in patients’ best medical interests when responding to invitations to speak to the media.
Identification beyond names
Patients may be identified by combinations of details other than names and addresses:
- Condition or disease.
- Age.
- Occupation.
- Area of residence.
- Medical history.
- Family size.
Patient data, including photographs, should not identify the patient.
Permission to tell a patient’s story
In a 2011 account of her practice, a paediatrician who wrote patient stories said she always asked the patient for permission to publish and changed details to protect identity wherever possible. When details could not be altered enough to conceal identity, she found that asking for and obtaining permission could resolve the difficulty.