Aspects of confidentiality: High-profile patients
One of the most commonly recurring issues that feature on the MPS advice line is confidentiality. In each edition of Casebook we will highlight an unusual scenario around confidentiality.
Public and media interest in the health and wellbeing of high-profile figures is not surprising. In this article we look at the contrasting experiences of two South African health ministers when it came to the confidentiality of their medical conditions.
In 2007, the late health minister Dr Manto Tshabalala-Msimang was admitted to the Johannesburg Hospital, suffering from anaemia and pleural effusion. Dr Tshabalala-Msimang later underwent a liver transplant. The stated cause was autoimmune hepatitis with portal hypertension, but the transplant was surrounded by accusations of heavy drinking. That these details made it into the public domain meant Dr Tshabalala-Msimang’s right to confidentiality had been breached.
Fast forward to August 2013. Current health minister Dr Aaron Motsoaledi was admitted to Steve Biko Academic Hospital, Pretoria, for an undisclosed procedure. His spokesperson confirmed to the media that Dr Motsoaledi had been admitted, but declined to give the reason – citing doctor–patient confidentiality.
The celebrity patient
The following examples from around the world highlight the damage that can be done when the security of computerised records is breached. In the United Kingdom, an audit carried out after a celebrity had been admitted to hospital in 2007 revealed that more than 50 staff who were not involved in his care had accessed his medical records. Media reports did not specify who the celebrity was, or which hospital it concerned, but the staff were presumably subjected to disciplinary proceedings.1
In the United States, the Hollywood actor George Clooney was admitted to the Palisades Medical Center following a motorbike accident. Subsequent to this, 27 staff who were not involved in his care were suspended without pay for accessing his medical records.2 In New Zealand, Auckland District Health Board fired one employee and disciplined 20 others “for examining the private medical records of celebrities”. The hospital routinely runs electronic audits after a celebrity has stayed in the hospital.3