Health privacy and confidentiality

The notion that a patient has the right to maintain the confidentiality of information disclosed in the course of a therapeutic relationship with a health practitioner has been entrenched in Western civilisation for thousands of years. For the first time, however we have begun to witness an erosion of this entitlement, especially in Australia in recent years. The Commonwealth Parliament has created a system of co-linked national electronic health records that, by virtue of new technology, permits government bodies and myriad other third parties to access and disseminate individuals' health information both lawfully and without authority, almost invariably in the absence of patients' knowledge and consent. Commonwealth legislation has also facilitated the substitution of patients' traditional right to confidentiality of their health information with a much broader and less clearly defined right to 'personal privacy'. This chapter examines how these changes have led to a fundamental upheaval of longstanding understandings about the protection of information communicated and learned in the once secluded space of the consulting room.