Emedinews: Sonia Gandhi to undergo surgery in US

UPA chairperson Sonia Gandhi will undergo surgery in the United States for an undisclosed medical condition. Not disclosing her condition is her right. Her doctors also cannot disclose her condition. Health bulletins are not allowed in the US.

Can a doctor disclose the medical condition of the patient?

(1998) 8 SCC 296: Supreme Court of India: CIVIL APPEAL NO. 4641 OF 1998

JUDGMENT S. SAGHIR AHMED. J.

1.    Principle of "duty of care", as applicable to persons in medical profession, includes the duty to maintain confidentiality.

2.     Duty to maintain confidentiality has its origin in the Hippocratic Oath, which is an ethical code attributed to the ancient Greek physician Hippocrates, adopted as a guide to conduct by the medical profession throughout the ages and still used in the graduation ceremonies of many medical schools and colleges. Hippocrates lived and practiced as physician between third and first century BC. He has referred to by Plato as a famous Asclepiad who has philosophical approach to medicine. His manuscripts, the Hippocratic Collection [Corpus Hippocracticum], contained the Hippocratic Oath which is reproduced below:

"I swear by Apollo the physician and Aesculapius and health and all-heal and all the gods and goddesses that according to my ability and judgment I will keep this oath and this stipulation - to reckon him who taught me this art equally dear to me as my parents, to share my substance with him and relieve his necessities if required, to look upon his offspring in the same footing as my own brothers and to teach them this art if they shall wish to learn it without fee or stipulation and that by precept, lecture, and every other mode of instruction I will impart a knowledge of the art to my own sons and those of my teachers and to disciples bound by a stipulation and oath according to the law of medicine but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked nor suggest any such counsel, and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my art. I will not cut persons laboring under the stone but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick and will abstain from every voluntary act of mischief and corruption, and further, from the seduction of females or males, of freeman and slaves. Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad. I will not divulge as reckoning that all such should be kept secret. While I continue to keep this oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times, but should I trespass and violate this oath, may the reverse be my lot."

3.    The Hippocratic Oath consists of two parts. The first, or covenant, is the solemn agreement concerning the relationship of apprentice to teacher and the obligations enjoined on the pupil. The second part constitutes the ethical code.

4.     It is on the basis of the above that the International Code of Medical Ethics has also laid down as under: "A Physician shall preserve absolute confidentiality on all he knows about his patient even after his patient has died."

5.     The Indian Medical Council Act controls medical education and regulates the professional conduct. Section 20A, which was inserted by the Indian Medical Council (Amendment) Act 1964 provides as under: Professional Conduct: 33: Code of ethics: "Do not disclose the secrets of a patient that have been learnt in the exercise of your profession. Those may be disclosed only in a Court of Law under orders of the presiding judge."

6.     In the doctor-patient relationship, the most important aspect is the doctor's duty to maintain secrecy. A doctor cannot disclose to a person any information regarding his patient which he has gathered in the course of treatment nor can the doctor disclose to anyone else the mode of treatment or the advice given by him to the patient.

7.     Hippocratic Oath as such is not enforceable in a court of law as it has no statutory force.

8.    Medical information about a person is protected by the code of Professional Conduct made by the Medical Council of India under Section 33(m) read with Section 20A of the Act.