physician-patient privilege

　

WordNet

1. the right of a physician to refuse to divulge confidential information from a patient without the consent of the patient
2. bestow a privilege upon (同)favor, favour
3. a special advantage or immunity or benefit not enjoyed by all
4. (law) the right to refuse to divulge information obtained in a confidential relationship
5. enduring trying circumstances with even temper or characterized by such endurance; "a patient smile"; "was patient with the children"; "an exact and patient scientist"; "please be patient"
6. a person who requires medical care; "the number of emergency patients has grown rapidly"
7. not subject to usual rules or penalties; "a privileged statement"
8. blessed with privileges; "the privileged few"

PrepTutorEJDIC

1. (免除・許可などの)『特権』,『特典』,恩典,恩恵 / …‘に'特権(特典)を与える
2. (人が)『忍耐強い』,しんぼう強い,がまん強い / (行動が)根気のよい,忍耐を示す / 〈C〉『患者』,医者にかかっている人
3. 特権(特典)のある
4. 『医者』;(特に)『内科医』

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/08/07 11:16:14」(JST)

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Evidence
Part of the common law series
Types of evidence
Testimony Documentary Real (physical) Digital Exculpatory Scientific Demonstrative Eyewitness identification Genetic (DNA) Lies
Relevance
Burden of proof Laying a foundation Public policy exclusions Spoliation Character Habit Similar fact
Authentication
Chain of custody Judicial notice Best evidence rule Self-authenticating document Ancient document Hague Evidence Convention
Witnesses
Competence Privilege Direct examination Cross-examination Redirect Impeachment Recorded recollection Expert witness Dead Man's Statute
Hearsay and exceptions
in English law in United States law Confessions Business records Excited utterance Dying declaration Party admission Ancient document Declaration against interest Present sense impression Res gestae Learned treatise Implied assertion
Other common law areas
Contract Tort Property Wills, trusts and estates Criminal law

Physician–patient privilege is a legal concept, related to medical confidentiality, that protects communications between a patient and his or her doctor from being used against the patient in court. It is a part of the rules of evidence in many common law jurisdictions. Almost every jurisdiction that recognizes physician-patient privilege not to testify in court, either by statute or though case law, limits the privilege to knowledge acquired during the course of providing medical services. In some jurisdictions, conversations between a patient and physician may be privileged in both criminal and civil courts.

Scope

The privilege may cover the situation where a patient confesses to a psychiatrist that he or she committed a particular crime. It may also cover normal inquiries regarding matters such as injuries that may result in civil action. For example, any defendant that the patient may be suing at the time cannot ask the doctor if the patient ever expressed the belief that his or her condition had improved. However, the rule generally does not apply to confidences shared with physicians when they are not serving in the role of medical providers.

The rationale behind the rule is that a level of trust must exist between a physician and the patient so that the physician can properly treat the patient. If the patient were fearful of telling the truth to the physician because he or she believed the physician would report such behavior to the authorities, the treatment process could be rendered far more difficult, or the physician could make an incorrect diagnosis.

For example, a below-age of consent patient came to a doctor with a sexually transmitted disease. The doctor is usually required to obtain a list of the patient's sexual contacts to inform them that they need treatment. This is an important health concern. However, the patient may be reluctant to divulge the names of his/her older sexual partners, for fear that they will be charged with statutory rape. In some jurisdictions, the doctor cannot be forced to reveal the information revealed by his patient to anyone except to particular organizations, as specified by law, and they too are required to keep that information confidential. If, in the case, the police become aware of such information, they are not allowed to use it in court as proof of the sexual conduct, except as provided by express intent of the Legislative Body and formalized into law.

United States

In the United States, the Federal Rules of Evidence do not recognize doctor-patient privilege.

At the state level, the extent of the privilege varies depending on the law of the applicable jurisdiction. For example, in Texas there is only a limited physician-patient privilege in criminal proceedings, and the privilege is limited in civil cases as well.

References

See also

• Privilege (evidence)
• Attorney–client privilege
• Doctor–patient relationship
• Subpoena duces tecum
• Subpoena ad testificandum

UpToDate Contents

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• 1. 医師と患者の関係における患者中心の考え方 a patient centered view of the clinician patient relationship
• 2. インフォームドコンセント informed consent
• 3. 手術室の安全性 operating room safety
• 4. 安楽死および医師幇助自殺 euthanasia and physician assisted suicide
• 5. 初回の出生前評価と親の教育 the initial prenatal assessment and patient education

English Journal

• Information, consent and treatment of patients with morgellons disease: an ethical perspective.

• Söderfeldt Y1, Groß D.Author information 1Institut für Geschichte, Theorie und Ethik der Medizin, Medizinische Fakultät der RWTH Aachen, Universitätsklinikum Aachen, Wendlingweg 2, 52074, Aachen, Germany, ysoederfeldt@ukaachen.de.AbstractMorgellons is a medically contested diagnosis with foremost dermatological symptoms. Patients experience fibers emerging from the skin, together with a range of other somatic, psychiatric, and neurological complaints. Within the medical community, it is generally held to be a variation of delusional parasitosis/delusional infestation, which is usually treated with antipsychotics. Little attention has been paid in the literature to the ethical aspects of treating patients with Morgellons disease. The communicative strategies suggested in the literature display significant ethical issues, primarily the use of therapeutic privilege, i.e. withholding information from the patient. Since this limits patient autonomy, that approach is ethically problematic. Instead, the physician has an ethical obligation to respect the patient's autonomy, provide full information, and seek consent before initiating a psychiatric referral.
• American journal of clinical dermatology.Am J Clin Dermatol.2014 Apr;15(2):71-6. doi: 10.1007/s40257-014-0071-y.
• Morgellons is a medically contested diagnosis with foremost dermatological symptoms. Patients experience fibers emerging from the skin, together with a range of other somatic, psychiatric, and neurological complaints. Within the medical community, it is generally held to be a variation of delusional
• PMID 24671866

• Personal statement to personal physician: bait and switch?

• Breen JO.AbstractIn our family medicine program, applicants' personal statements largely speak to the value of trusting, continuous doctor-patient relationships. They give poignant examples of patient interactions that have allowed the applicants to experience the privilege of the intimacy with which patients relate to their doctors. Whatever their true motivations for choosing family medicine, the relational values expressed in the personal statement are the ones we celebrate and incentivize in the residency selection process. However, after donning their freshly pressed white coats, new interns in family medicine hear different definitions of value applied to their chosen specialty.
• The Hastings Center report.Hastings Cent Rep.2014 Mar;44(2):25-7. doi: 10.1002/hast.291.
• In our family medicine program, applicants' personal statements largely speak to the value of trusting, continuous doctor-patient relationships. They give poignant examples of patient interactions that have allowed the applicants to experience the privilege of the intimacy with which patients relate
• PMID 24634045

• The need to know--therapeutic privilege: a way forward.

• Hodkinson K.Author information Bioethics and Medical Jurisprudence, School of Law, University of Manchester, Oxford Road, Manchester M13 9PL, UK. kate.hodkinson@postgrad.manchester.ac.ukAbstractProviding patients with information is fundamental to respecting autonomy. However, there may be circumstances when information may be withheld to prevent serious harm to the patient, a concept referred to as therapeutic privilege. This paper provides an analysis of the ethical, legal and professional considerations which impact on a decision to withhold information that, in normal circumstances, would be given to the patient. It considers the status of the therapeutic privilege in English case law and concludes that, while reference is made to circumstances when information (primarily in relation to risk disclosure) may be withheld, further clarification is required on the status of therapeutic privilege. I suggest there has been shift in English law relating to the standard of information disclosure towards one set by the test of the reasonable, prudent patient. It is this shift that necessitates the existence of a therapeutic privilege which enables doctors to withhold information that would usually be given to the patient in order to prevent serious harm. I then explore the professional guidance in relation to information disclosure and how this relates to the legal position. There are strong ethical arguments in favour of disclosure of information to patients. In light of these, further clarification is required to identify and define the grounds on which this exception exists, the information that could lawfully be withheld and how this exception extends to rest of the health care team, particularly nurses. As such, explicit ethical and legal scrutiny of therapeutic privilege is needed in order to consider how this concept might be articulated, constrained and regulated.
• Health care analysis : HCA : journal of health philosophy and policy.Health Care Anal.2013 Jun;21(2):105-29. doi: 10.1007/s10728-012-0204-5.
• Providing patients with information is fundamental to respecting autonomy. However, there may be circumstances when information may be withheld to prevent serious harm to the patient, a concept referred to as therapeutic privilege. This paper provides an analysis of the ethical, legal and profession
• PMID 22382452

Related Links

• Physician–patient privilege - Wikipedia, the free encyclopedia

Physician–patient privilege is a legal concept, related to medical confidentiality, that protects communications between a patient and his or her doctor from being used against the patient in court. It is a part of the rules of evidence in many ...

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関連記事	「privilege」「physician」

「privilege」

　　[★]

• n.

• (官職・地位などに伴う)特権、特典、特別扱い。(個人的な)恩典、(特別な)恩恵、名誉
• (the ～)(基本的な人権による)権利

• vt.

• ～に特権/特典を与える。(禁じられている物を)特別に認可/許可する。得tんとして免除する(from)(exempt)

　 　 　 　

「physician」

　　[★]

• n.

• 医者、医師(=doctor)、内科医