Medical confidentiality: the right of a commanding officer to know

Recent changes in the law and in patients' expectations have necessitated alterations to the way doctors maintain the medical confidentiality of their patients. This paper investigates the ethical and legal aspects of medical confidentiality in general, examines their relation to the military context and analyses the guidance offered. Military personnel give up some individual rights on enlistment. The requirement for the medical officer to share patients' medical information, without consent if necessary, with the Commanding Officer is ethically and legally acceptable provided recruits are adequately warned of this restriction to human rights before joining. Although the paper concentrates on the guidance given in the RAF, the principles are common to the 3 Armed Forces' medical services.