Confidentiality of health information postmortem

Recent discussions of health care privacy have prompted new concerns over the control of private health information after a patient's death. The importance of confidentiality protections postmortem is compounded as genetic technologies and research capabilities advance and public interest in this information increases.

The Council on Ethical and Judicial Affairs of the American Medical Association developed this report to guide physicians in the management of patients' health information postmortem.

This report was developed by the 9 physician members of the Council on Ethical and Judicial Affairs with the assistance of staff from the Ethics Standards Group at the American Medical Association.

Literature searches in the MEDLINE and BIOETHICSLINE databases using the search terms postmortem and health information qualified with confidentiality or privacy yielded a combined total of 129 references. Additional references were culled from policies of a number of health care organizations.

The Council on Ethical and Judicial Affairs solicited suggestions from the federation of state medical and specialty societies before drafting this report. A copy of the report was sent to the College of American Pathologists for comment. It was then adopted by a majority vote of the House of Delegates of the American Medical Association.

The report emphasizes the importance of maintaining confidentiality for information held within a deceased patient's medical record. However, these protections are subject to certain exceptions. Confidentiality can be upheld when such information is used for educational or research purposes by removing individual identifiers. For disclosures in which the identity of the deceased patient is known, a number of considerations are provided to assess when disclosure would be ethically permissible.