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9780754622949

Medical Confidentiality and Crime

by
  • ISBN13:

    9780754622949

  • ISBN10:

    0754622940

  • Format: Hardcover
  • Copyright: 2003-09-28
  • Publisher: Routledge

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Summary

Medical confidentiality is universally recognised as a value worth protecting. However, difficulties arise when confidential medical information becomes relevant in the context of crime prevention and criminal prosecution. Based on an examination of different approaches in medical ethics and a comparison of the relevant law of France, Germany, England and Wales and the US, this book analyses how a balance of the competing interests can best be struck.

Table of Contents

Acknowledgements xi
Table of Cases xiii
Table of Legislation xxv
List of Abbreviations xxxi
CHAPTER 1: INTRODUCTION 1(1)
CHAPTER 2: ETHICAL CONSIDERATIONS 1(33)
1 Main schools of medical ethics
8(4)
1.1 Utilitarianism
8(1)
1.2 Deontological theories
9(3)
1.2.1 A duty-based approach
9(1)
1.2.2 A rights-based approach
10(1)
1.2.3 A principle-based approach
11(1)
2 Autonomy, privacy and confidentiality
12(8)
2.1 Principle of autonomy
12(1)
2.2 Privacy
13(3)
2.3 Medical confidentiality
16(4)
3 Conflicts of interests in the context of criminal prosecution and crime prevention
20(11)
3.1 Strict confidentiality?
20(1)
3.2 Medical confidentiality and the administration of criminal justice
21(7)
3.2.1 Utilitarian approaches
22(3)
3.2.2 Deontological approaches
25(3)
3.3 Medical confidentiality and the interests of third parties
28(6)
3.3.1 Crime prevention
28(3)
3.3.2 Defence rights
31(1)
4 Conclusion
31(3)
CHAPTER 3: EUROPEAN LAW 34(13)
Part 1 Protection of medical confidentiality
34(4)
1 European Convention on Human Rights
34(3)
2 European Convention on Human Rights and Biomedicine
37(1)
3 Data Protection Directive 95/46/EC
37(1)
4 European Charter of Fundamental Rights
38(1)
Part 2 Disclosure in the context of crime prevention and criminal prosecution
38(9)
1 Criminal prosecution
39(3)
2 Conflicting defence rights
42(2)
3 Crime prevention
44(2)
4 Summary
46(1)
CHAPTER 4: FRENCH LAW 47(43)
Part 1 Protection of medical confidentiality
47(13)
1 Medical confidentiality as a fundamental right
1.1 Constitutional right
47(2)
1.2 European Convention on Human Rights
49(1)
2 Protection under criminal law
50(7)
3 Protection under private law
57(2)
3.1 Article 9 of the Civil Code
57(1)
3.2 Obligation under contract and tort law
58(1)
4 Professional obligation
59(1)
5 Summary
59(1)
Part 2 Disclosure in the context of crime prevention and criminal prosecution
60(30)
1 General and absolute obligation of medical confidentiality
60(2)
2 Obligation to give testimony
62(1)
3 Defence rights of the physician
63(5)
4 Effects of the patient's consent
68(6)
5 Obligation to disclose certain information
74(6)
5.1 Crime prevention
74(2)
5.2 Child abuse
76(2)
5.3 Protection of the innocent
78(2)
6 Admissibility of the physician's testimony
80(1)
7 Search for and seizure of medical records
80(1)
8 Summary and conclusion
81(9)
CHAPTER 5: GERMAN LAW 90(37)
Part 1 Protection of medical confidentiality
90(12)
1 Medical confidentiality as a fundamental right
90(6)
1.1 Protection under the German Constitution
90(5)
1.2 European Convention on Human Rights
95(1)
2 Protection under criminal law
96(3)
3 Protection under contract and tort law
99(1)
4 Professional obligation
100(1)
5 Summary
101(1)
Part 2 Disclosure in the context of crime prevention and criminal prosecution
102(25)
1 A physician's testimony in criminal court
102(12)
1.1 Refusal to testify - right or obligation?
105(3)
1.2 Effects of the patient's consent
108(1)
1.3 Disclosure for the purpose of criminal prosecution
109(2)
1.4 Testimony to establish the innocence of an accused
111(3)
2 Crime prevention
114(3)
3 Confidential material exempt from search and seizure
117(8)
3.1 Protection of the accused
119(4)
3.2 Custody requirement
123(1)
3.3 Effect of the patient's consent
124(1)
3.4 The physician's right to submit confidential material
125(1)
4 Summary and conclusion
125(2)
CHAPTER 6: ENGLISH LAW 127(71)
Part 1 Protection of medical confidentiality
127(30)
1 Medical confidentiality as a fundamental right
127(2)
2 Contractual obligation
129(1)
3 Equitable duty
129(25)
3.1 Obligation of confidence
130(6)
3.2 Confidential quality of the information
136(9)
3.3 Breach of duty
145(2)
3.4 Detriment
147(1)
3.5 Remedies
148(1)
3.6 Purpose behind equitable protection of medical confidentiality
149(5)
4 Statutory obligations and criminal offences
154(1)
5 Professional obligation
155(1)
6 Summary
156(1)
Part 2 Disclosure in the context of crime prevention and criminal prosecution
157(41)
1 State access to confidential medical information
158(18)
1.1 Medical privilege in criminal court
158(12)
1.2 Legal professional privilege
170(2)
1.3 Police access to confidential medical information
172(4)
1.3.1 Definition of excluded material
173(1)
1.3.2 Application for an order giving access to excluded material
174(1)
1.3.3 Access to excluded material without court order
175(1)
2 Voluntary disclosure by the physician
176(19)
2.1 Submission of medical records to the police
177(2)
2.2 Disclosure for the purpose of criminal prosecution
179(5)
2.3 Disclosure to assist the defence
184(4)
2.4 Disclosure for the purpose of crime prevention
188(7)
3 Summary and conclusion
195(3)
CHAPTER 7: AMERICAN LAW 198(76)
Part 1 Protection of medical confidentiality
198(31)
1 Constitutional privacy protection
198(15)
1.1 Fifth Amendment (Self-Incrimination Clause)
199(2)
1.2 Fourth Amendment (Unreasonable search and seizure)
201(3)
1.3 Fourteenth Amendment (Substantive due process)
204(8)
1.4 Privacy protection under State constitutions
212(1)
2 Statutory obligations
213(10)
2.1 Privilege statutes
213(10)
2.2 Licensing statutes
223(1)
3 Private law actions for breach of medical confidentiality
223(4)
3.1 Obligation of medical confidentiality
223(1)
3.2 Obligation under contract law
224(1)
3.3 Action under tort law
225(2)
4 Professional obligation
227(1)
5 Summary
227(2)
Part 2 Disclosure in the context of crime prevention and criminal prosecution
229(45)
1 Federal law
229(6)
2 State law
235(35)
2.1 Reasons behind the recognition of privilege
235(5)
2.2 Limitations to medical privilege
240(44)
2.2.1 General considerations
240(1)
2.2.2 Interests in criminal prosecution and the administration of justice
241(8)
2.2.3 A special problem: child abuse
249(1)
2.2.4 A special problem: drunk driving
250(1)
2.2.5 Investigations against the physician
251(2)
2.2.6 Conflicting defence rights
253(13)
2.2.7 Crime prevention
266(4)
3 Summary and conclusion
270(4)
CHAPTER 8: COMPARATIVE CONCLUSIONS 274(59)
Part 1 Protection of medical confidentiality
275(9)
1 Constitutional protection
275(4)
2 Scope and means of protection
279(4)
3 Differences between common law and civil law approaches
283(1)
Part 2 Disclosure in the context of crime prevention and criminal prosecution
284(46)
1 Medical privilege in criminal courts
284(22)
1.1 Recognition of medical privilege
284(9)
1.2 Medical privilege only for minor offences?
293(4)
1.3 Psychotherapist patient privilege
297(1)
1.4 Medical privilege at the discretion of the physician?
298(3)
1.5 Effect of the patient's consent
301(1)
1.6 Medical records
302(2)
1.7 Prosecution of the physician
304(1)
1.8 Conclusion
305(1)
2 Defence rights
306(12)
2.1 Defence rights of the patient
306(1)
2.2 Defence rights of third parties
306(7)
2.3 Defence rights of the physician
313(1)
2.4 Protection of the innocent
314(3)
2.5 Conclusion
317(1)
3 Crime prevention
318(12)
3.1 Obligation to disclose
318(1)
3.2 Justification of disclosure
319(2)
3.3 Balancing of interests
321(8)
3.3.1 Weight of the conflicting interests
322(1)
3.3.2 Danger, imminence of the risk and general risks of life
323(3)
3.3.3 Avoidability of the risk
326(1)
3.3.4 Proportionality of disclosure
327(2)
3.4 Conclusion
329(1)
Part 3 Concluding remarks
330(3)
Bibliography 333(10)
Index 343

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