Re-evaluating confidentiality: using patient information in teaching and publications†

Case studies used in psychiatry for teaching and learning can include large amounts of personal information, and most medical journals refuse to publish case material without patient consent. However, not all patients are capable of consenting and maintaining anonymity is not always successful. Disclosure of personal information without consent can cause a sense of violation, but a principle of non-violation rigorously applied would prohibit the use of such material without consent, even if the patient is completely unidentifiable. A public interest argument can be made for using patient information for teaching purposes. Furthermore, a limited case can be made for using, and even publishing, some cases without consent, e.g. those requiring urgent public discussion or concerning people who are incapable of giving consent. Thus, an argument can be put forward for relaxing to this limited degree the demand for patient consent to publish case material. Heather Draper is Senior Lecturer in Biomedical Ethics at the University of Birmingham (Centre for Biomedical Ethics, Department of Primary Care and General Practice, Primary Care (T) Building, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. E-mail: [email protected]). She has been teaching medical/healthcare ethics (and some law) to medical students and postgraduates from a variety of healthcare backgrounds since the mid-1980s. She writes on a range of ethical issues, but her primary research focus is reproductive technology. Wendy Rogers is Associate Professor of Medical Ethics and Health Law in the School of Medicine at Flinders University, Adelaide, Australia. She currently teaches health law and ethics to students and practitioners in a range of healthcare professions. Her research interests include ethics of evidence-based medicine, ethical issues in general practice, feminist healthcare ethics and public health ethics. †For invited commentaries on this article see pp. 122–123 and pp. 123–124, this issue.