COVID-19疫情下之醫師保密義務初探【本期企劃】 試閱
COVID-19 and the Physician’s Duty of Confidentiality
COVID-19疫情引發許多影響醫病關係之倫理與法律議題，包括醫師保密義務之範圍與界限。由於COVID-19患者與疑似感染者之健康資訊已被廣泛運用在防疫措施，醫師是否可能因其揭露義務之擴張而導致保密義務受到挑戰，便引起關注。舉例而言，雖然醫師依據傳染病控制法有義務於發現傳染病或疑似傳染病時報告當地主管機關，並因此構成保密義務之例外，但醫師報告之資訊類別與數量、或強制通報義務內涵能否因COVID-19疫情發展而擴張，並未有清楚規範；另如遠距醫療（通訊診察治療）因COVID-19疫情擴散而被廣泛運用，作為提供檢疫／居家隔離者或一般民眾健康照護之重要模式以降低感染風險，但現行醫師保密義務之規範要求是否足以應對新興技術所帶來之隱私風險，亦引起質疑。為因應COVID-19疫情對醫師保密義務所形成之挑戰，現行醫師保密義務法律規範應重新檢討評估，主管機關並應提供適當指引，當中包含保密義務豁免之具體條件或病患隱私保護之技術建議。
The COVID-19 pandemic has given rise to a number of ethical and legal issues affecting the physician patient relationship in Taiwan, including the scope of the physician’s duty of confidentiality. Because the personal health information of COVID-19 patients and suspected cases has been broadly used in different measures to combat the spread of the novel virus, many are alarmed that the perception of patient-physician confidentiality may be challenged. For example, even though physicians are required to report COVID cases or suspected cases to the authority and their confidentiality duty can be waived in accordance with the Communicable Disease Control Act, it remains unclear what type and amount of information can be disclosed to the authority and whether the disclosure can be further expanded during the pandemic. Additionally, when telemedicine/telehealth has been widely used for people in quarantine or for the general public to minimize the risk of COVID-19 transmission, it remains questionable whether the current confidentiality requirements is sufficient to cope with the privacy risks posed by the new technologies. To respond to the limited exploration of the physician’s duty of confidentiality during the pandemic, current statues and regulations regarding the duty should be reevaluated. Additionally, confidentiality waivers and technical advices on the protection of patient’s confidentiality during the pandemic should be clearly elaborated in the guidelines provided by the government.
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