Medical Confidentiality in Spain
First off, what is medical secrecy?
Medical secrecy or confidentiality is one of the core duties of the medical practice. It implies that health care providers must keep patients’ personal health information private, unless the patient provides consent to release the information.
Medical secrecy is almost as old as medicine itself, from the Hippocratic Oath (IV century BC) to the current Codes of Medical Ethics; all of them establishing medical confidentiality as one of the pillars of the doctor-patient relationship, the real keystone of health care.

Patients seeking medical help should not be hindered by fear that their medical conditions will be disclosed to third parties, as precise information is needed in order to make a correct diagnosis and treatment planning, creating a trusting environment is essential.
The obligation of preserving privacy covers any information coming to the doctor’s attention in the doctor-patient relationship context. Such responsibility also continues after the patient stops being treated by his/her doctors, even after the patient’s death. However, the duty of confidentiality is not absolute. Health professionals may disclose personal information, against the patient’s will, under very limited circumstances such as: notifiable diseases or court order.

Most confidence breaks are committed unintentionally; some of them due to inadequate infrastructure or poor organization; most of them when informing patients’ families in hospital wards, operating rooms, etc. On the contrary, there can occasionally be severe breaches in an intentional manner, for instance: doctors consulting medical data of people who are not their patients, disclosing information to a third party without patients’ consent, and so on. In those cases a breach of confidence constitutes an act of misconduct in terms of criminal and professional law.

If a patient thinks that a doctor has wrongly breached secrecy, he or she should pursue his/her complaint through the Medical Council or criminal grievance procedures. Failure to comply with the rules of the General Medical Council Ethics Code and Spanish laws implies severe consequences. Infringing the rules involves incurring disciplinary penalties and contravention of the law can be harshly punished. It can entail imprisonment of one to four years, a fine and the inability to practice the profession for two to six years.

Not only is ensuring confidentiality both an ethical and legal duty for health professionals, but it is also a social constraint. Although health professionals, as a whole, are concerned about this issue, (and medical education gives more and more importance to confidentiality), patients and users of the health system also should collaborate and report about the possible failures in order to correct them.

Marta Arroyo Domingo
Escuela Oficial de Idiomas de Molina de Segura