Subject: Bioethics

Topic: 4.02 – Professional Secrecy

Lecturer: Dr. Sheila Refuerzo Yap
Date: November 17, 2014

III. THE SECRET AND TRUTHFULNESS

OUTLINE  Without truthfulness, the mutual trust which is basic to social and
I. Types of Secrets professional life is impossible.
II. The Professional Secret  The question then arises as to whether it would be licit to lie.
III. The Secret and Truthfulness o ANSWER:NO
OBJECTIVES  “It is never licit to lie; one however is not always obliged to reveal
At the end of the lecture, the student should be able to: the truth. On certain occasions, one may be obliged to keep
1. Understand the meaning of professional secrets silent.”
2. Apply the principles of professional secrecy in medical practice
 Guidelines:
References: Dr. Yap’s lecture powerpoint o Never lie or deceive the patient
I. TYPES OF SECRETS o One is not obliged to tell the truth if one judges that revelation
could have a negative effect upon the patient.
 Natural Secret
o Keep silent about the truth or evade questions.
o Things that by their very character require to be kept secret
A. WHEN CAN A SECRET BE DIVULGED?
 Promised Secret
o That which after being known, the person who has been  With the consent of the interested party
informed promises not to reveal it  If the patient knowingly and freely authorizes the physician to
o Secret  promise to keep it reveal information, there is no moral objection
 Confided secret o Example:
o That which is communicated and received under a pledge Prior to acceptance, the insurance company requires
required as a precedent condition not to reveal it information regarding an applicant’s state of health and
o Promise to keep it  secret past medical history.
o Professional secret = confided secret  For the public good
II. PROFESSIONAL SECRET o Private property including a secret becomes common in
A. Who keeps the secret? common necessity.
o The observance of professional secrecy would cease if it
 Doctors
would be more harmful than helpful for the common good.
 Lawyers
o Example:
 Psychologists
 PD 169 Harm to oneself or to others
 Advisers  The state requires the reporting of all communicable
 He who takes on a profession implicitly obligates himself faithfully diseases (RA 3573 Law on Reporting of Communicable
to keep the secrets which its exercise brings to his knowledge Diseases)
 These people can share and discuss with their colleagues, but they  RA 7610 Special Protection of Children Against Abuse,
are not allowed to drop names. Exploitation and Discrimination Act
B. 3 Qualities of the Medical-Professional Secret  The professional secret needs to be divulged when a patient having
1. Pertains to the field of medical profession lost his right to natural secrecy by becoming an unjust aggressor is
2. Known in and on account of its exercise threatening harm to an innocent third party under the cover of
3. Its revelation would damage the patient in his reputation or professional secrecy.
in some good that is valued in society  A patient who has a highly contagious disease which would
C. Why is it kept a secret? render him sterile is going to marry but refuses to inform
 4 Ethical Principles his fianceé.
o Respect for person  Does the doctor have an obligation to reveal the patient’s
 Privacy: the right of every person condition to the intended bride?
 Confidentiality: the duty of those involved in treatment  And if he does not have an obligation, is he permitted to do
o Beneficence so?
 What good will it do the patient?  “At times, the physician faces the dilemma of whether or not to tell
 How will it benefit the patient? the spouse of the patient about serious medical findings (sterility
o Non-maleficence problems, impotence, venereal disease). In these cases, the
 Primum Non Nocere physician should act with common sense, judge the goods at stake
o Justice and act accordingly. He is certainly obliged to inform about
D. Legal Bases of Privacy and Confidentiality diriment impediments to marriage.” (Code of Canon Law canon
 1987 Philippine Constitution 1069)
o The privacy of communication and correspondence shall be
inviolable except upon lawful order of the court or when  Parting Question: Is it better to tolerate a private injustice and
public safety and order requires otherwise as prescribed by maintain confidence in the profession – which constitutes
law (Art III, sec 3.1) an excellent public good– or allow deterioration of
 New Civil Code confidence in the profession to prevent a concrete private
o Every person shall respect the dignity, personality, privacy and injustice?
peace of mind of his neighbors and other persons (Article 26)

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