Egypt's Grand Mufti, Dr. Nazir Ayyad, addressed a question concerning whether a doctor may withhold the true nature of a patient's illness when revealing it could cause serious physical or psychological harm.
He explained that the general principle is for a doctor to tell the patient the truth about their medical condition. However, if the doctor determines, based on professional experience and knowledge of the patient's condition, that disclosure would likely result in significant physical or psychological deterioration, withholding the information may be permissible.
According to the ruling, such withholding is not considered blameworthy concealment when it is intended to protect the patient and achieve a legitimate benefit. It falls within the scope of permissible indirect communication and compassionate reassurance, provided that it remains limited to the extent necessary.
Conditions for Withholding a Diagnosis
The Grand Mufti emphasized that withholding information must remain within the limits of genuine need and should not become a general practice that deprives the patient of important rights or appropriate care.
When necessary, relevant family members or another person designated by the patient may be informed, where possible, in order to protect the patient's rights and ensure proper care.
The patient's dignity must also be preserved, and the method of communication should remain humane and appropriate.
When May a Doctor Disclose Patient Confidentiality?
Regarding the disclosure of patient secrets when other people may be harmed, the Grand Mufti explained that confidentiality is the general rule.
A doctor may not disclose information learned through professional practice unless there is a legitimate necessity. If the doctor is certain that serious harm could extend to other people, the relevant authorities should be informed so that appropriate preventive measures can be taken.
One example is a contagious disease that poses a serious risk of transmission to others. Another may involve information connected to a criminal act where withholding the information could leave others exposed to significant harm.
Disclosure Must Be Limited
An exception to medical confidentiality does not mean that the patient's private information can be shared freely.
Any disclosure should be limited to the competent authorities or individuals who genuinely need the information and only to the extent required to prevent the harm.
If a doctor reveals confidential information to unrelated people without a legitimate reason, the doctor may be considered to have breached the professional trust placed in them.
When Is Disclosure of Patient Information Permissible?
Disclosure may be permissible, and in some circumstances necessary, when there is a clear and serious risk to other people and reporting is required to prevent that harm.
The purpose of disclosure must be protecting others and preventing a significant harm, rather than exposing, humiliating, or publicly criticizing the patient.
The principle is therefore one of necessity and proportionality: information should be disclosed only to the extent required to achieve the legitimate purpose.
Medical Confidentiality and the Public Interest
Medical confidentiality is a fundamental part of the relationship between doctors and patients because patients provide sensitive information in reliance on professional trust.
However, confidentiality may have limited exceptions when keeping the information secret would result in serious and certain harm to others, or when applicable law requires reporting specific situations.
At the same time, these exceptions should remain narrowly defined and should not turn into a general permission to disclose patient information.
Conclusion
The Grand Mufti explained that the general rule is for patients to be informed about their medical conditions. However, a doctor may withhold the diagnosis when professional judgment indicates that disclosure would cause significant physical or psychological harm.
Similarly, patient confidentiality remains the general rule, but disclosure may become permissible or required when there is a genuine necessity involving serious and certain harm to others. Even then, disclosure must be limited to the competent authorities and only to the information necessary to address the risk.
Can a doctor withhold a serious diagnosis from a patient?
Yes, when the doctor determines that disclosure would cause significant physical or psychological harm and withholding the information serves a legitimate patient interest.
Should patients normally be told the truth about their illness?
Yes. Informing the patient about their medical condition is the general rule, subject to legitimate exceptions.
Can a doctor disclose a patient's confidential information?
The general rule is confidentiality, but disclosure may be permissible or required when there is a genuine necessity and a serious, certain risk to others.
Can a doctor tell anyone about a patient's condition?
No. When disclosure is justified, it should be limited to the relevant authorities or people who need the information and only to the necessary extent.
What if a doctor discloses confidential information without necessity?
Such disclosure may constitute a breach of professional confidentiality and trust and may expose the doctor to professional or legal consequences.
