Doctors have an ethical and legal obligation to maintain confidentiality.

The General Medical Council (GMC) which regulates doctors' professional conduct, accepts, however, that this is not an absolute duty. The GMC’s guidance, Confidentiality: Protecting and Providing Information (April 2004) sets out exceptions to the duty of confidentiality. In particular, paragraph 27 states:

“Disclosure of personal information without consent may be justified in the public interest where failure to do so may expose the patient or others to risk of death or serious harm. Where the patient or others are exposed to a risk so serious that it outweighs the patient’s privacy interest, you should seek consent to disclosure where practicable. If it is not practicable to seek consent, you should disclose information promptly to an appropriate person or authority. You should generally inform the patient before disclosing the information. If you seek consent and the patient withholds it you should consider the reasons for this, if any are provided by the patient. If you remain of the view that disclosure is necessary to protect a third party from death or serious harm, you should disclose information promptly to an appropriate person or authority. Such situations arise, for example, where a disclosure may assist in the prevention, detection or prosecution of a serious crime, especially crimes against the person, such as abuse of children.”

Doctors who decide to disclose confidential information must be prepared to explain and justify their decisions (paragraph 26).

An individual can also consent to the disclosure of information concerning his or her health status. This is usually expressed, i.e. where the person concerned actually gives permission. It can, however, be implied, where a person is assumed to have given consent for all the healthcare team involved in his/her treatment to have been informed of all the relevant information. The guidance makes it clear that the doctor has the responsibility to inform the person concerned as to the nature and extent of the disclosure and to allow them the opportunity to object.

The guidance confirms a doctor's continuing professional obligation to keep information confidential after a death (paragraph 30). However, see Access to medical records for further information on the right of access by certain third parties to a dead person's medical records. Further, it is unlikely that a court would uphold a claim for breach of confidence in such circumstances: “as the confidence is prima facie a personal matter, the legal duty ends with the death of the patient” (Mason, McCall Smith and Laurie, Law and Medical Ethics (6^th edn 2002), para 8.66).