A female patient at a medical centre consulted GP Dr F and was subsequently sent for further treatment at another department within the building. Dr F supplied the patient with her medical notes, to be passed on at her next consultation. The notes were contained in a ‘family file’ and the patient flicked through it with curiosity. She discovered her husband’s notes and a diagnosis – three years earlier, and unknown to her – that he was HIV positive.

The husband complained to the medical centre about the violation of his patient confidentiality. He also sent a complaint to the HPCSA, who strongly criticised Dr F over his practice of keeping ‘family files’.

In what was a related issue, the wife complained that she should have been informed of her husband’s HIV diagnosis, as she would have taken the necessary precautions to protect herself. MPS advised Dr F that at the time of the HIV diagnosis, he should have counselled the husband on disclosing his status to his wife, who should then have been offered testing (with the necessary counselling). If he refused to disclose his status to her, consideration should have been given to this being disclosed to the wife by Dr F, after having warned the husband that this would be done.

Although it is a breach of patient confidentiality, such a disclosure is justified if somebody else’s (the wife’s) health (and life) is at risk. See the MPS factsheet on “Disclosures without consent”.