Medical Confidentiality Argument Analysis

Medical confidentiality is a major issue in the medical field today due to consequences caused by keeping and breaking patient-doctor confidentiality. M. A. Crook addresses this issue in, “The Risks of Absolute Medical Confidentiality”, which discusses the holes in the argument that patient confidentiality should always be upheld. Crook presents detailed examples of scenarios in which confidentiality should have been broken and provides credible sources to support his opinion. Certain aspects of Crook’s argument enable it to be an overall well-written and persuasive article.

Crook begins his argument by reviewing the definition of confidentiality. He states that confidentiality, in terms of patients and clinicians, is “a duty of confidence,

which arises when one person discloses information to another” (107). This definition coincides with what medical confidentiality means, but Crook continues to define absolute confidentiality as only reasonable when it makes sense to keep it confidential. Although this introduction comes across as fairly biased, the introduction pulls readers towards his side considering the definition favors Crook’s belief. He does a good job at introducing people to the general topic before diving into his own opinion. Before he even begins the major parts of his article, he is allowing readers to understand the topic.
Then, following the definition, Crook explains that The National Health Service (NHS), which contains important medical documents, is so large and complex that “such a system is thus at significant risk of security breaches and violation of patient confidentiality” (107). The reference to the NHS benefits his argument since the NHS is a credible organization. Referring to a national organization increases his credibility coercing readers to take his side. With the mention of the NHS, he also provides a viable reason as to why this national organization would have issues when it comes to keeping absolute confidentiality. This statement is not just an assumption. This statement comes from a creditable source. Most opinionated statements throughout the article are not his own opinion but a statement from a credible source. This makes most of Crook’s statements more believable and increases his credibility.
Crook then summarizes the two main arguments supporting absolute confidentiality and presents a counter argument for both.

The first claim is that “Absolute confidentiality reduces harm within the doctor-patient relationship” (Crook 108). His summarization provides reasonable claims as to why confidentiality may be important to patients. Crook states that “patients may be reticent in disclosing information to their doctors, lie about or conceal embarrassing facts” (108). His statements in the first claim contradict his belief, but in order for readers to understand the claim he is arguing against, Crook needs to explain both sides. Explaining both sides of the overall argument of confidentiality allows readers to understand both opinions and decide whether or not Crook provides reasonable evidence to contradict his opposing

argument.
Crook’s counterargument of the first claim immediately discusses the effect of keeping absolute confidentiality has on death. He presents two examples of occurrences in which a doctor did not tell a third party of a patient’s illness, causing one or multiple casualties. He begins his argument with a heavy point. The examples he provides definitely help his argument considering they address life or death. They severely contradict the previous claim that absolute confidentiality reduces harm. His first point for his counterargument is substantial, provoking a reader’s strong opinion for the rest of the article.
Crook continues his counterargument with directly disagreeing with an absolutist’s argument. Crook states, “The absolutist’s arguments are unable to provide evidence supporting the notion that patients would not seek treatment if they thought their data would be revealed” (109). Not only does Crook point out that the absolutist holds no evidence for his or her claim, but, yet again, paraphrases this statement from another source increasing his credibility and support system. He points out that his counterargument has no evidence to support the belief that confidentiality is necessary which is extremely beneficial to his argument. If there is no evidence supporting Crook’s counterargument, it’s almost impossible to disagree with Crook. However, Crook then claims that confidentiality has to be “balanced against public interest” (109). He automatically assumes that, in general, the public agrees with him. This assumption is not valid providing he has no evidence to support this assumption. Although Crook’s overall argument is justifiable and understandable, part of his counterargument contains assumptions which creates holes.
The rest of Crook’s counterargument to the reduction of harm because of absolute confidentiality addresses issues that doctors only need common sense to understand and side with.

His examples include problems with confidentiality causing harm to public health and not actually benefiting the doctor-patient relationship. For example, Crook speaks of a time in which doctors were not able to find patients in a hospital because managers would not show the names of patients above their beds. He asserts, “This is potentially an extremely dangerous governance situation as clinical staff need to correctly and quickly and access patients” (Crook 111). It’s almost impossible for a doctor to disagree with this statement because it uses hard evidence and makes perfect

sense.
Crook’s counterarguments to the assumption that there is “no obligation of beneficence thus no justification to breach confidentiality” (114) also contain hard evidence and comparisons that undoubtedly influence readers. In Crook’s summary of the argument of beneficence, he uses a hypothetical case from Kipnis. Kipnis tells of a case in which a man has not told his wife, Wilma, about an infectious disease. The doctor in this case does not feel the need to tell the wife because he “cannot be absolutely sure the husband will necessarily infect his wife” (Crook 113). Crook later addresses this claim by stating, “His argument that the doctor cannot be sure that Wilma will be infected by HIV is like arguing that a terrorist who throws a grenade into a crowded room is not guilty of murder as they thought there was a small likelihood that anyone would be killed” (114). This comparison discusses a valid situation and addresses an issue of important value to people. By addressing terrorism as a comparison to a flaw in confidentiality, Crook initiates a certain response from readers that favors his opinion. Terrorism is, of course, a serious matter and its impact is severe, just as keeping absolute confidentiality is. The statement catches readers’ attention and undoubtedly influences their thoughts.
The issue of patient confidentiality will continue to be discussed due to the consequences of both sides of the argument, but Crook’s argument against absolute confidentiality for the most part overpowers the countering claims. His article contains influential points that can’t possibly be ignored. His article is well-written and structured, but the content of the article is what really stands out and helps support Crook’s argument.