Dual loyalties 1.14
Pressures on the doctor
Prison doctors could be put under pressure to share information about a prisoner's health status with non-medical staff -- and in circumstances where such knowledge would NOT clearly or necessarily be in the best interests of the patient. Prison administration and officers often consider that they should have access to all the information in the prisoner's medical records. Many prison doctors experience this as dilemma.
The prison officers are their colleagues and the doctors do not want to come into conflict with them. It could be seen as disloyal not to pass information about the prisoners' health on to the officers. But the prison doctors remain under an ethical obligation to maintain confidentiality as far as the circumstances allow and to resist pressure to give open access to prison health records. There are, however, two important exemptions, one of which has been mentioned above:
Contagious diseases with serious risk to third parties
To ensure the prisoners access to treatment
As a general rule the medical staff should not disclose any confidential information. Contagious diseases like TB and HIV carry a stigma and the prisoner should be taken into treatment without prison staff knowing what the diagnosis is. In prison settings this may be very theoretical. However, prison doctors should see to it that so far as possible, confidentiality is indeed respected. Non-medical staff should only have access to specific information, as the need arises, so as to give the patient correct treatment. If the danger of infecting the other prisoners is high special measures may of course then be taken.
The European Committee on the Prevention of Torture (CPT) underline that all medical examination should be conducted out of hearing and sight of prison officers unless the doctors concerned request otherwise in a particular case, for example if he feels that his safety is threatened Visit: The CPT standards - "Substantive" sections of the CPT's General Reports