The physician’s duty of confidentiality is based on the observance of the patient’s privacy and intimacy and on the importance of respecting both of these rights, thus creating a relationship of confidence and collaboration between doctor and patient. The main objective of this work consists of analyzing the aspects that are related to the confidentiality of patients’ data with respect to the training, conduct and opinions of doctors from different Clinical Management Units of a third-level hospital via a questionnaire. The present study aimed to define the problem and determine whether the opinions of these professionals correspond to those observed in a previous work conducted at the same center. Of the 200 questionnaires that were collected, 62.5% were from consultants and the rest were from residents (37.5%) with an average of 14.4 ± 12.5 years in professional practice. The respondents noted habitual situations in which confidentiality was breached in the reference hospital (74%). The section on their attitudes and behaviors towards situations related to confidentiality showed a slightly lower average score than that of their medical knowledge; significant differences in these scores were observed between the consultants and residents as well as between the extreme age groups (≤ 30 vs. ≥ 51 years) and years of professional practice, thus more inadequate attitudes were consistently noted in younger doctors who had fewer years of experience. Finally, the respondents answered that the training of doctors in the aspects of healthcare law and ethics was the most important measure that the hospital could adopt regarding confidentiality practices.
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Barnable, A., Cunning, G., & Parcon, M. (2018). Nursing students’ perceptions of confidentiality, accountability, and e-professionalism in relation to facebook. Nurse Educator, 43(1), 28–31.
Beltran-Aroca, C. M., Girela-Lopez, E., Collazo-Chao, E., Montero-Perez-Barquero, M., & Munoz-Villanueva, M. C. (2016). Confidentiality breaches in clinical practice: What happens in hospitals? BMC Medical Ethics, 17(1), 52.
Bernat, J. L. (2013). Ethical and quality pitfalls in electronic health records. Neurology, 80(11), 1057–1061.
Brann, M., & Mattson, M. (2004). Toward a typology of confidentiality breaches in health care communication: An ethic of care analysis of provider practices and patient perceptions. Health Communication, 16(2), 231–251.
Caine, K., & Tierney, W. M. (2015). Point and counterpoint: Patient control of access to data in their electronic health records. Journal of General Internal Medicine, 30(Suppl 1), S38–S41.
Clamp, P. J., Grant, D. G., Zapala, D. A., & Hawkins, D. B. (2011). How private is your consultation? Acoustic and audiological measures of speech privacy in the otolaryngology clinic. European Archives of Oto-Rhino-Laryngology, 268(1), 143–146.
Cortes Generales. (1978). Constitución Española. BOE, 311, 29313–29424.
Dapaah, J. M., & Senah, K. A. (2016). HIV/AIDS clients, privacy and confidentiality; the case of two health centres in the Ashanti Region of Ghana. BMC Medical Ethics, 17(1), 41.
Dodek, D. Y., & Dodek, A. (1997). From Hippocrates to facsimile. Protecting patient confidentiality is more difficult and more important than ever before. Canadian Medical Association Journal, 156(6), 847–852.
Eikey, E. V., Murphy, A. R., Reddy, M. C., & Xu, H. (2015). Designing for privacy management in hospitals: Understanding the gap between user activities and IT staff’s understandings. International Journal of Medical Informatics, 84(12), 1065–1075.
Elger, B. S. (2009). Violations of medical confidentiality: opinions of primary care physicians. British Journal of General Practice, 59(567), e344–e352.
European Commission, European Observatory on Health Systems and Policies, KU Leuven, & Maastricht University. (2018). Patients’ rights in the European Union mapping exercise. Final report. Publications Office of the European Union. https://publications.europa.eu/en/publication-detail/-/publication/8f187ea5-024b-11e8-b8f5-01aa75ed71a1/language-en. Accessed 24 September 2018.
EuroSOCAP. (2006). Directrices europeas sobre confidencialidad y privacidad en la asistencia sanitaria. http://www.asepp.es/documentos/. Accessed 28 September 2018.
Grady, C., Jacob, J., & Romano, C. (1991). Confidentiality: A survey in a research hospital. Journal of Clinical Ethics, 2(1), 25–30.
Grande, D., Asch, D. A., Wan, F., Bradbury, A. R., Jagsi, R., & Mitra, N. (2015). Are patients with cancer less willing to share their health information? Privacy, sensitivity, and social purpose. Journal of Oncology Practice, 11(5), 378–383.
Gupta, S. G. (2013). Tips for telephone and electronic medical consultation. Indian Journal of Pediatrics, 80(11), 944–948.
Hodgson, J., Mendenhall, T., & Lamson, A. (2013). Patient and provider relationships: Consent, confidentiality, and managing mistakes in integrated primary care settings. Families, Systems, & Health, 31(1), 28–40.
Holanda Pena, M. S., Ots Ruiz, E., Dominguez Artiga, M. J., Garcia Miguelez, A., Ruiz Ruiz, A., Castellanos Ortega, A., et al. (2015). Measuring the satisfaction of patients admitted to the intensive care unit and of their families. Medicina Intensiva, 39(1), 4–12.
Iraburu, M., Chamorro, J., & de Pedro, M. T. (2006). Knowledge, conduct and opinions of health professionals concerning confidentiality at a hospital. Anales del sistema sanitario de Navarra, 29(3), 357–366.
Iraburu, M., Seoane, J. A., & Gaminde, I. (2012). The culture of confidentiality in Northern Spain hospitals. Medicina Clinica (Barcelona), 139(2), 76–81.
Jayabalan, M., & O’Daniel, T. (2016). Access control and privilege management in electronic health record: A systematic literature review. Journal of Medical Systems, 40(12), 261.
Jefatura del Estado. (1999). Ley Orgánica 15/1999, de 13 de diciembre, de Protección de Datos de Carácter Personal. BOE, 298, 43088–43099.
Jefatura del Estado. (2002). Ley 41/2002, de 14 de noviembre, básica reguladora de la autonomía del paciente y de derechos y obligaciones en materia de información y documentación clínica. BOE, 274, 40126–40132.
Jefatura del Estado. (2018). Real Decreto-ley 5/2018, de 27 de julio, de medidas urgentes para la adaptación del Derecho español a la normativa de la Unión Europea en materia de protección de datos. BOE, 183, 76249–76257.
Kayaalp, M. (2018). Patient privacy in the era of big data. Balkan Medical Journal, 35(1), 8–17.
Kong, G., & Xiao, Z. (2015). Protecting privacy in a clinical data warehouse. Health Informatics Journal, 21(2), 93–106.
Lehnbom, E. C., Brien, J. E., & McLachlan, A. J. (2014). Knowledge and attitudes regarding the personally controlled electronic health record: An Australian national survey. Internal Medicine Journal, 44(4), 406–409.
Lin, Y. K., Lee, W. C., Kuo, L. C., Cheng, Y. C., Lin, C. J., Lin, H. L., et al. (2013). Building an ethical environment improves patient privacy and satisfaction in the crowded emergency department: A quasi-experimental study. BMC Medical Ethics, 14, 8.
Llamas-Sanchez, F., Flores-Cordon, J., Acosta-Mosquera, M. E., Gonzalez-Vazquez, J., Albar-Marin, M. J., & Macias-Rodriguez, C. (2009). Needs of the families in a Critical Care Unit. Enferm Intensiva, 20(2), 50–57.
Markel, H. (2004). “I swear by Apollo”—On taking the Hippocratic oath. New England Journal of Medicine, 350(20), 2026–2029.
McKinstry, B., Watson, P., Pinnock, H., Heaney, D., & Sheikh, A. (2009). Confidentiality and the telephone in family practice: A qualitative study of the views of patients, clinicians and administrative staff. Family Practice, 26(5), 344–350.
Ministerio de Sanidad, Servicios Sociales e Igualdad. (2017). Orden SSI/81/2017, de 19 de enero, por la que se publica el Acuerdo de la Comisión de Recursos Humanos del Sistema Nacional de Salud, por el que se aprueba el protocolo mediante el que se determinan pautas básicas destinadas a asegurar y proteger el derecho a la intimidad del paciente por los alumnos y residentes en Ciencias de la Salud. BOE, 31, 8277–8289.
Mira, J. J., Ferrus, L., Silvestre, C., & Olivera, G. (2017). What, who, when, where and how to inform patients after an adverse event: A qualitative study. Enfermería Clínica, 27(2), 87–93.
Mlinek, E. J., & Pierce, J. (1997). Confidentiality and privacy breaches in a university hospital emergency department. Academic Emergency Medicine, 4(12), 1142–1146.
Neame, R. L. (2014). Privacy protection for personal health information and shared care records. Informatics in Primary Care, 21(2), 84–91.
Olsen, J. C., Cutcliffe, B., & O’Brien, B. C. (2008). Emergency department design and patient perceptions of privacy and confidentiality. Journal of Emergency Medicine, 35(3), 317–320.
Olsen, J. C., & Sabin, B. R. (2003). Emergency department patient perceptions of privacy and confidentiality. Journal of Emergency Medicine, 25(3), 329–333.
Organización Médica Colegial of Spain. (2011). Código de Deontología Médica. Guía de Ética Médica. Madrid: OMC.
Page, S. A., & Mitchell, I. (2006). Patients’ opinions on privacy, consent and the disclosure of health information for medical research. Chronic Diseases in Canada, 27(2), 60–67.
Peek, N., Holmes, J. H., & Sun, J. (2014). Technical challenges for big data in biomedicine and health: Data sources, infrastructure, and analytics. Yearbook of Medical Informatics, 9, 42–47.
Peguero, E., Berenguera, A., Pujol-Ribera, E., Roman, B., Prieto, C. M., & Terribas, N. (2015). The workers opinions have a value in the Code of Ethics: Analysis of the contributions of workers in virtual Forum Catalan Institute of Health. BMC Medical Ethics, 16(1), 90.
Poorchangizi, B., Farokhzadian, J., Abbaszadeh, A., Mirzaee, M., & Borhani, F. (2017). The importance of professional values from clinical nurses’ perspective in hospitals of a medical university in Iran. BMC Medical Ethics, 18(1), 20.
Rieder, P., Louis-Courvoisier, M., & Huber, P. (2016). The end of medical confidentiality? Patients, physicians and the state in history. Medical Humanities, 42(3), 149–154.
Roberts, L. W., Johnson, M. E., Brems, C., & Warner, T. D. (2008). When providers and patients come from different backgrounds: Perceived value of additional training on ethical care practices. Transcultural Psychiatry, 45(4), 553–565.
Santana Cabrera, L., Sanchez Palacios, M., Hernandez Medina, E., Garcia Martul, M., Eugenio Ronaina, P., & Villanueva Ortiz, A. (2007). Needs of the family of intensive care patients: Perception of the family and the professional. Medicina Intensiva, 31(6), 273–280.
Scott, K., Dyas, J. V., Middlemass, J. B., & Siriwardena, A. N. (2007). Confidentiality in the waiting room: An observational study in general practice. British Journal of General Practice, 57(539), 490–493.
Shahriari, M., Mohammadi, E., Abbaszadeh, A., Bahrami, M., & Fooladi, M. M. (2012). Perceived ethical values by Iranian nurses. Nursing Ethics, 19(1), 30–44.
Sher, M. L., Talley, P. C., Cheng, T. J., & Kuo, K. M. (2017). How can hospitals better protect the privacy of electronic medical records? Perspectives from staff members of health information management departments. Health Information Management Journal, 46(2), 87–95.
Sokol, D., & Car, J. (2006). Protecting patient confidentiality in telephone consultations in general practice. British Journal of General Practice, 56(526), 384–385.
Sturman, N. J., & Saiepour, N. (2014). Ethics and professionalism in general practice placements: What should students learn? Australian Family Physician, 43(7), 468–472.
Tahim, A., Sabharwal, S., Dhokia, R., Bajekal, R., & Kyriacou, S. (2012). Data protection training improves data handling. The Clinical Teacher, 9(6), 403–407.
Ubel, P. A., Zell, M. M., Miller, D. J., Fischer, G. S., Peters-Stefani, D., & Arnold, R. M. (1995). Elevator talk: Observational study of inappropriate comments in a public space. American Journal of Medicine, 99(2), 190–194.
Union Europea. (2016). Reglamento (UE) 2016/679 del Parlamento Europeo y del Consejo, de 27 de abril de 2016, relativo a la protección de las personas físicas en lo que respecta al tratamiento de datos personales y a la libre circulación de estos datos y por el que se deroga la Directiva 95/46/CE (Reglamento general de protección de datos). DOUE, 119, 1–88.
Viccellio, P., Zito, J. A., Sayage, V., Chohan, J., Garra, G., Santora, C., et al. (2013). Patients overwhelmingly prefer inpatient boarding to emergency department boarding. Journal of Emergency Medicine, 45(6), 942–946.
Vigod, S. N., Bell, C. M., & Bohnen, J. M. (2003). Privacy of patients’ information in hospital lifts: Observational study. BMJ, 327(7422), 1024–1025.
Wallace, I. M. (2015). Is patient confidentiality compromised with the electronic health record?: A position paper. Computers, Informatics, Nursing, 33(2), 58–62. (quiz E51).
Zhang, X. C., Kobayashi, L., Berger, M., Reddy, P. M., Chheng, D. B., Gorham, S. A., et al. (2015). Objective assessment and thematic categorization of patient-audible information in an emergency department. Academic Emergency Medicine, 22(10), 1222–1225.
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Beltran-Aroca, C.M., Labella, F., Font-Ugalde, P. et al. Assessment of Doctors’ Knowledge and Attitudes Towards Confidentiality in Hospital Care. Sci Eng Ethics 25, 1531–1548 (2019). https://doi.org/10.1007/s11948-018-0078-5
- Healthcare law
- Medical knowledge
- Professional questionnaire
- Ethical behavior