Challenges for privacy preservation in healthcare systems.

There is no national law to preserve patient’s privacy, so how can this right be protected?

Bioethical’s duty is to mediate conflicts that everyday’s medical practice create. Those conflicts are in constant change and now are focused on the need to protect personal data and patient’s confidentiality, which may be in risk with technological development.

Privacy relates with individual’s decision making power: He/she can decide which informations can be shared and who it can be shared with. Confidentiality, on the other hand, is the doctor’s professional duty not to share patient’s personal information.  

Both principles are not and should not be absolute, as the growing use of medical technology allows more doctors and nurses to access patient’s informations without even asking for the individual’s consent. However, even though those principles are not absolute, they have to be protected.

Internationally, patient’s privacy and confidentiality became a concern in the 70’s, when several “patient’s rights declarations” were made, as the Declaration on the rights of the Patients” (1981).

In Brazil,  there is no national law on patient’s rights and those rights are protected only by the Medical Code of Ethics and other professional norms.

In Brazil,  there is no national law on patient’s rights and those rights are protected only by the Medical Code of Ethics and other professional norms.

The lack of national legislation raises concerns especially considering that the use of technological systems by the national health system (SUS/DATASUS). For those kind of system, the principle of informed consent for patient data’s use does not suffice anymore, as systems, softwares and databases are interconnected. Therefore, one should use, instead, the principle of anonymization of the information in order to protect it.

National health system’s softwares and systems have two internal levels: in the first level one can find general information on health, using anonymous data; In the second level, one can find information that can be identified and linked to a patient. As health data collected and stored in the systems are sensitive, there must be a public debate on how to elaborate public policies and laws to control the usage and openness of that information.

 

Available here (text in Portuguese).