We clarify that the confidentiality of a patient’s medical data and details is NOT ABSOLUTE. Article III, Section 3 of the Code of Ethics of the Medical Profession provides that “the physician shall hold as private and highly confidential whatever may be discovered or learned pertinent to the patient…, except when required by law, ordinance or administrative order in the promotion of justice, safety and public health”. The Health Privacy Code Specifying the Joint A.O. No. 2016-0002, “Privacy Guidelines for the Implementation of the Philippine Health Information Exchange” in Rule III (Use and Disclosure of Health Information) paragraph 1.3 provides: “… in case of emergency, where time is of the essence, disclosure may be made even without court order.” Confidentiality can be lifted “…b) when the public health and safety so demand; or c) when the patient waives this right”.
In view of the increasing incidents of COVID-19+ patients seeking treatment or admission in clinics/hospitals without divulging their true condition thereby compromising the health institutions and the health workers therein; the difficulty, if not the inability of the government to conduct timely, adequate and complete contact tracing; the multiplying number of unknowing virus carriers who are not properly tested, quarantined, isolated, or treated; the requirement of basic fairness to those who might have been infected so that they can take precautionary/remedial measures; and the obvious tilting of the balance in favor of the pressing demands of public health and safety over individual rights, WE EARNESTLY REQUEST:
1) That COVID 19+ patients or PUI’s (Persons Under Investigation) VOLUNTARILY WAIVE the confidentiality of their medical condition and forthrightly inform those they have been in close contact with;
2) That the government, particularly the Department of Health, prudently uses and promptly shares medical information to enable all concerned authorities, institutions and persons to effectively take precautionary and remedial measures.
Being diagnosed as COVID-19+ is not a sin, a crime, or a stigma. But it is inequitable and counter-productive for COVID 19+ patients or PUI’s to conceal their true condition thereby possibly infecting health workers and depriving those with whom they may have been in close contact the opportunity to take the necessary precautionary or remedial measures. We empathize with the COVID-19+ patients and they and their families should be given support, understanding, compassion, and protection. We reiterate our call that they should not be discriminated against.
We, however, pray that their tragedy be turned into heroism by their honesty and voluntary waiver of confidentiality of their medical condition for the greater good. By being candid, the COVID-19+ patients and PUI’s will help most their family members, friends, co-workers and those they were close with. …”. Section 9 paragraphs d) and e) of R.A. 11332 (Surveillance and Response to Notifiable Diseases, Epidemics, and Health Events of Public Health Concern) should warn us that “non-cooperation” in times of public health emergencies is illegal.
Existing laws and rules grant the government sufficient authority and basis to lift the confidentiality of the medical condition of COVID-19+ patients and PUI’s. We, therefore, urge the government to promptly provide (with adequate safeguards) to all health institutions, concerned law enforcers, and responsible local authorities, the medical data of patients to avoid further infection, facilitate contact tracing, and promptly alert those affected. The present pandemic requires proactive and decisive steps that must be based on facts, science, and the law, not on politics, posturing, or partiality.
The National Privacy Commission Bulletin No. 3, dated March 19, 2020, aptly states: “The Data Privacy Act of 2012 is an enabler in critical times like this” and that “during this time, it is not only the “misuse” of data that concerns us but also the “missed” use that could have made a difference in containing the disease”.
We make this public clarification and plea in the spirit of bayanihan as we continue to contribute in our little ways to the common effort to contain COVID-19, and to protect or save lives.
(Joint statement of the Integrated Bar of the Philippines, Philippine Medical Association, and Philippine College of Surgeons, 4 April 2020)