醫師保密義務之例外

The Exceptions for Physician’s Confidentiality Obligation

為病人守密是基本的醫學倫理原則，也是醫病間信賴關係的基礎。然而不管在倫理或法律上都承認在某些情境下，醫師必須違背守密原則揭露病人的病情資訊。本文探討醫師保密義務之例外，以愛滋病與癲癇兩疾病情境為例進行倫理法律分析，援引英國醫學總會（General Medical Council，GMC）發布之守密倫理指引提供處置建議，並指出我國法規與倫理規範所致疑慮，以及可提升之方向。

Keeping confidentiality for patients is a basic principle of medical ethics; it is also the foundation of trustful physician-patient relationships. However, it is ethically and legally recognized that doctors might have to disclose patience’s confidential information under certain circumstances. In this paper we explore the exceptional situations when doctors may violate patients’ privacy, use cases of HIV and epilepsy as examples for ethical legal analysis, apply the confidentiality guidelines published by UK General Medical Council (GMC) for resolutions, and reflect upon the shortcomings of Taiwan’s current ethical-legal regulations and suggest possible improvement.