AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. July 2011, Volume 13, Number 7: 475-477.


  • Print
  • |
  • View PDF

The AMA Code of Medical Ethics’ Opinions on Confidentiality of Patient Information

The AMA Code of Medical Ethics' opinions on confidentiality of patient information.

Opinion 9.124 - Professionalism in the Use of Social Media

The Internet has created the ability for medical students and physicians to communicate and share information quickly and to reach millions of people easily. Participating in social networking and other similar Internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication. Social networks, blogs, and other forms of communication online also create new challenges to the patient-physician relationship. Physicians should weigh a number of considerations when maintaining a presence online:

  1. Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.
  2. When using the Internet for social networking, physicians should use privacy settings to safeguard personal information and content to the extent possible, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently. Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate.
  3. If they interact with patients on the Internet, physicians must maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines just, as they would in any other context.
  4. To maintain appropriate professional boundaries physicians should consider separating personal and professional content online.
  5. When physicians see content posted by colleagues that appears unprofessional they have a responsibility to bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions. If the behavior significantly violates professional norms and the individual does not take appropriate action to resolve the situation, the physician should report the matter to appropriate authorities.
  6. Physicians must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers (particularly for physicians-in-training and medical students), and can undermine public trust in the medical profession.

Issued June 2011, based on the report “Professionalism in the Use of Social Media.”

Opinion 5.051 - Confidentiality of Medical Information Postmortem

All medically related confidences disclosed by a patient to a physician and information contained within a deceased patient’s medical record, including information entered postmortem, should be kept confidential to the greatest possible degree. However, the obligation to safeguard patient confidences is subject to certain exceptions that are ethically and legally justifiable because of overriding societal considerations (Opinion 5.05 Confidentiality). At their strongest, confidentiality protections after death would be equal to those in force during a patient’s life. Thus, if information about a patient may be ethically disclosed during life, it likewise may be disclosed after the patient has died.

Disclosure of medical information postmortem for research and educational purposes is appropriate as long as confidentiality is maintained to the greatest possible degree by removing any individual identifiers. Otherwise, in determining whether to disclose identified information after the death of a patient, physicians should consider the following factors:

  1. The imminence of harm to identifiable individuals or the public health
  2. The potential benefit to at-risk individuals or the public health (e.g., if a communicable or inherited disease is preventable or treatable)
  3. Any statement or directive made by the patient regarding postmortem disclosure
  4. The impact disclosure may have on the reputation of the deceased patient
  5. Personal gain for the physician that may unduly influence professional obligations of confidentiality

When a family member or other decision maker has given consent to an autopsy, physicians may disclose the results of the autopsy to the individual(s) that granted consent to the procedure.

Issued December 2000, based on the report “Confidentiality of Medical Information Postmortem," adopted June 2000. Updated December 2001.

Anonymous Physician Blogging, July 2011

The Case History and Deferred Pain, July 2011

When Doctors Pick up the Pen—Patient-Doctor Confidentiality Breaches in Publishing, July 2011

Case Studies and the Therapeutic Relationship, July 2011

Ethics, Memoir, and Medicine, July 2011