Privilege, confidentiality, and patient privacy: status 1980

The principle of patient privacy has evolved from the Hippocratic Oath to current medical ethics guidelines and to legal protections for doctor-patient communications. Privilege statutes now abound in the United States with considerable difference from state jurisdiction to state jurisdiction. Recently several bills have been introduced to establish a federal standard for patient privacy. These bills are critically examined--particularly in regard to the conflict between the need to keep doctor-patient interactions private and the demand by law enforcement agencies for information. The federal bills lean towards the latter at the expense of the protection of confidentiality and therefore should not be adopted. The narrowness of the scope of the proposed laws is reflected in a comparison with a proposed model privacy act.