Should a doctor tell? : medical confidentiality in interwar England and Scotland
Medical confidentiality is integral to the doctor - patient relationship and an important element in efficient and effective medical practice. However, it is generally acknowledged that medical confidentiality can not be absolute. At times it must be broken in order to serve a ‘higher’ interest - be it public health or the legal justice system. Yet, very little is known about the historical evolution of the boundaries of medical confidentiality in Britain. The absence of detailed historical research on the subject has meant that contemporary writers have tended to use citations of the Hippocratic Oath or short quotations from key legal cases to place their work into longer term context. The current thesis provides a more detailed examination of the delineation of the boundaries of medical confidentiality during a period of intense debate - the interwar years of the twentieth century. The increase in state interest in the health of the population, the growth in divorce after the First World War and the prominence of the medical issues of venereal disease and abortion, all brought unprecedented challenges to the traditional concept of medical confidentiality. Having examined the, oft-cited, benchmark precedent for medical confidentiality from the late eighteenth century, the thesis proceeds to examine the ways in which medicine had changed by the interwar years. The high-point of the debate in the early 1920s is examined from the perspective of the three key interest groups - the Ministry of Health, the British Medical Association and the Lord Chancellor. Overall, the work provides insight into the historical delineation of medical confidentiality in Britain, both in statute and common law. As such it lends a longer-term context to current debates over the boundaries of medical confidentiality in the twenty-first century.