Understanding Patient Confidentiality: Key Health Law Insights

Patient confidentiality is one of healthcare’s foundational principles. It is both an ethical standard and a legal obligation for healthcare professionals and is vital to building and maintaining patient trust in healthcare practices and systems.¹

For lawyers and non-lawyers working in fields such as healthcare compliance, patient confidentiality law – such as the Health Insurance Portability and Accountability Act (HIPAA)² – is one of the most significant elements of health law.
This blog post examines several aspects of patient confidentiality in healthcare, including patient privacy, ethical principles governing confidentiality, and the legal frameworks that protect personal medical information.

What Is Patient Confidentiality?

Patient confidentiality is not the same as privacy. As a legal concept in the U.S., privacy is a right, anchored in the Constitution by the Fourth Amendment.³ It is a right to freedom from intrusion on your personal space (physical privacy) or personal information (informational privacy).

Confidentiality is slightly different. It is considered a professional ethical obligation. Confidentiality describes a professional duty not to share certain information with third parties.³ This obligation only attaches to certain types of information and particular professions. For example, your doctor has an ethical duty not to share your medical information with third parties without your permission, but a waiter is free to tell anyone your lunch order.

In a medical context, patient privacy describes your right to a private consultation with a doctor (i.e., not being observed by interns or other individuals without your permission). Patient confidentiality dictates that a doctor must protect your medical information from being accessed by third parties without your permission.⁴

So if a receptionist shouts “Mr. Smith – herpes” across a crowded waiting room, that would be considered a breach of Mr. Smith’s right to privacy. Leaving Mr. Smith’s medical chart unattended in an unlocked car also constitutes a breach of confidentiality and a failure of the professional duty to protect private medical information.

The Intersection of Law and Confidentiality Ethics

The principle of confidentiality in medical ethics derives from autonomy, one of the four core principles (beneficence, nonmaleficence, autonomy, and justice).⁵

Autonomy is defined essentially as a patient’s right to make their own decisions about their medical care. From this principle, we derive several important concepts, such as informed consent (the necessity to provide patients with sufficient information so that they can make an educated choice about their options for medical care), truth-telling (an obligation to be honest with patients so that they have the best possible information), and confidentiality in medical affairs (the obligation to protect patient information from unauthorized access).⁵

Healthcare providers must balance ethical and legal requirements. For example, medical professionals might be permitted to breach confidentiality if a patient is considered a risk to themselves or to others. Minors are often exempt from confidentiality requirements because they aren’t legally responsible for their decisions; for example, parents receive their children’s medical information. And in a situation where a minor was the apparent victim of a crime, a medical professional is legally and morally obliged to notify authorities.⁶

Patient Confidentiality in Healthcare Practice

Fortunately for healthcare providers, patient confidentiality is a well-regulated concept. The legal requirements and limits of confidentiality are well described by regulations such as HIPAA.

The law mandates that healthcare providers take action to protect medical records and digital data. This typically includes ensuring that records are password-protected, not kept for longer than necessary, regularly audited, and regularly backed up.⁷

Administrators and compliance officers play an important role in publicizing and enforcing policies. This includes clearly communicating professional obligations and standards and educating staff about their responsibilities.

Common Violations and Legal Consequences

HIPAA requires healthcare providers to protect patients’ private medical information from unauthorized access. This also includes a legal obligation to train staff about confidentiality issues and take reasonable steps to secure data.

As such, some of the most common HIPAA breaches are essentially oversights: failure to implement HIPAA compliance training or conduct risk analysis, for example.⁸ Such breaches would typically be treated as noncompliance issues. These are enforced by the U.S. Department of Health and Human Services Office for Civil Rights (OCR). Civil penalties for noncompliance range from fines of a few hundred dollars for “unknowing” violations to a maximum of $1.5 million in fines per year for willful neglect and repeated refusal to correct the issue.⁹

Criminal violations of HIPAA, such as knowingly selling private information for profit, can attract severe financial penalties and lengthy prison sentences (up to $250,000 and 10 years in prison).⁹

Advance Your Expertise in Health Law With Hofstra Law

Patient confidentiality and privacy are two of the most significant ethical and legal obligations in healthcare. For healthcare compliance professionals, administrators, and managers, managing institutional and individual compliance with confidentiality regulations in medical environments is a critical responsibility.

Hofstra University’s suite of online Health Law and Policy programs is designed to equip lawyers and non-lawyers with specialist knowledge of the legal landscape of modern healthcare. The online LLM in Health Law and Policy is for practicing attorneys who wish to develop an expertise in health law. The online Master of Arts in Health Law and Policy offers non-lawyers an immersive focus on essential legal concepts, including patient privacy, healthcare compliance, and bioethics. Both lawyers and non-lawyers can kickstart their journey toward subject-matter expertise with the online Certificate in Health Law and Policy, a nine-credit program you can complete in as few as eight months with credit applied toward either the LLM or MA programs.

To discuss how Hofstra Law can help advance your career and expertise in health law, schedule a call with an admissions outreach advisor today.