Contesting Medical Confidentiality : Origins of the Debate in the United States, Britain, and Germany

Medical confidentiality is an essential cornerstone of effective public health systems, and for centuries societies have struggled to maintain the illusion of absolute privacy. In this age of health databases and increasing connectedness, however, the confidentiality of patient information is rapidly becoming a concern at the forefront of worldwide ethical and political debate. In __Contesting Medical Confidentiality__, Andreas-Holger Maehle travels back to the origins of this increasingly relevant issue. He offers the first comparative analysis of professional and public debates on medical confidentiality in the United States, Britain, and Germany during the late nineteenth and early twentieth centuries, when traditional medical secrecy first came under pressure from demands of disclosure in the name of public health. Maehle structures his study around three representative questions of the time that remain salient today: Do physicians have a privilege to refuse court orders to reveal confidential patient details? Is there a medical duty to report illegal procedures to the authorities? Should doctors breach confidentiality in order to prevent the spread of disease? Considering these debates through a unique historical perspective, __Contesting Medical Confidentiality__ illuminates the ethical issues and potentially grave consequences that continue to stir up public debate. Privacy and medical confidentiality are currently issues of considerable public concern, especially regarding the management and sharing of patient information in health databases. This book for the first time comparatively elucidates the origins of the debates on medical confidentiality in the USA, Britain and Germany during the late nineteenth and early twentieth centuries. In this period traditional medical secrecy began to be seriously contested by demands for disclosure in the name of public health and the law. Three major debates are analyzed in this book: on a “privilege” of physicians and surgeons to refuse giving evidence in court about confidential patient details; on doctors’ breaches of patient confidence in order to prevent the spread of venereal diseases; and on a medical duty to report illegal abortions to the authorities. The comparative approach reveals significant differences between the three countries concerned, for instance regarding their recognition of a medical privilege in court and their policies on notification of cases of venereal disease, as well as similarities, for example in the reluctance of doctors to report abortion cases. The book analyzes the ethical arguments used to support different positions in conflicts between individual and collective interests in confidentiality or disclosure, and highlights the often differing standpoints of medical and legal professionals. The historical perspective illuminates the fundamental ethical issues at stake, which continue to give rise to public debate Medical confidentiality is an essential cornerstone of effective public health systems, and for centuries societies have struggled to maintain the illusion of absolute privacy. In this age of health databases and increasing connectedness, however, the confidentiality of patient information is rapidly becoming a concern at the forefront of worldwide ethical and political debate. Andreas-Holger Maehle travels back to the origins of this increasingly relevant issue. He offers a comparative analysis of professional and public debates on medical confidentiality in the United States, Britain, and Germany during the late 19th and early 20th centuries, when traditional medical secrecy first came under pressure from demands of disclosure in the name of public health