Dr K K Aggarwal

The Govt. has drafted a healthcare security law Digital Information in Healthcare Security Act (DISHA) and has invited comments and suggestions before 21st April. It has been proposed that “Any person who commits a serious breach of health care data shall be punished with imprisonment, which shall extend from three years and up to five years; or fine, which shall not be less than five lakh of rupees”.

I had been called as a special invitee for the meeting wherein this draft was being discussed. I had just taken over as the Secretary General IMA at that time. In the meeting, I voiced my opposition to this particular clause and said that the medical profession will not accept any penal provisions in this act. Because India is not yet ready to accept penal provisions for privacy and confidentiality clause.

The only thing happened at that time was that I was never again invited for any further meeting on this.

In a country where there may be say ten patients in the same OPD room at one point of time; OT lists are pasted in open corridors, patients name are shouted outside OT or ICU, and where there is no system of proxy consent or defined person to whom we should counsel, how can we talk about penal provisions for confidentiality of the patient.

MCI Code of Ethics Regulations and IT act already have adequate provisions in this regard.

2.2 Patience, Delicacy and Secrecy: Patience and delicacy should characterize the physician. Confidences concerning individual or domestic life entrusted by patients to a physician and defects in the disposition or character of patients observed during medical attendance should never be revealed unless their revelation is required by the laws of the State. Sometimes, however, a physician must determine whether his duty to society requires him to employ knowledge, obtained through confidence as a physician, to protect a healthy person against a communicable disease to which he is about to be exposed. In such instance, the physician should act as he would wish another to act toward one of his own family in like circumstances.  

7.14 The registered medical practitioner shall not disclose the secrets of a patient that have been learnt in the exercise of his / her profession except –

1. in a court of law under orders of the Presiding Judge;
2. in circumstances where there is a serious and identified risk to a specific person and / or community; and
3. notifiable diseases.

In case of communicable / notifiable diseases, concerned public health authorities should be informed immediately.

7.17. A registered medical practitioner shall not publish photographs or case reports of his / her patients without their permission, in any medical or other journal in a manner by which their identity could be made out. If the identity is not to be disclosed, the consent is not needed.

 Declaration g: I will respect the secrets which are confined in me.