Disclosure of medical records

The Hans India: New Delhi: Tuesday, 28 April 2015.

Section 8(1)(j) of RTI Act provides that personal information need not be disclosed unless the larger public interest justifies it.  If the information is personal or would amount to invasion of privacy of the individual, what the Public Information Officer has to satisfy is whether the larger public interest justifies the disclosure. The Bombay High Court said that the Regulations framed under the Indian Medical Council Act, will have to be read with Section 8(1) (j) of the Right to Information Act.

If a spouse is subjected to suffering because of incurable disease of other spouse, it is a ground for divorce. Section 13(i)(v) of the Hindu Marriage Act, 1955, provides that a marriage can be dissolved on the ground that the other party has been incurably of unsound mind, or has been suffering continuously or intermittently from mental disorder of such a kind and to such an extent that the petitioner cannot reasonably be expected to live with the respondent

Information about one’s disease is ‘personal’; others should not be interested in it. But there are exceptions. When public money is spent on treating disease, the information relating to that public interest shall be revealed.  

When disease of one person is affecting rights of the other, public interest demands disclosure of such information. Misss JJ sought for copies of all papers, documents, records, old medical records, case history records etc available with Institute of Human Behaviour and Allied Sciences (IHBAS) in relation to her husband Sanjay Singh. She alleged that she was physically tortured due to his mental illness. Her brother alleged that her husband and his relatives have suppressed the truth about his mental health to cheat her into marriage, which proved a hell for her thereafter. The PIO replied that information is related to the psychiatric medical information, thus exempted under section 8(1)(e).

The First Appellate Authority stated that the medical record was held by public authority in the capacity of fiduciary relationship and the information belonged to third party. However the FAA advised the deemed PIO, the MRO that the copies of the old medical records of the patient, if brought by the Appellant at the time of treatment/admission, after due verification, be provided to the appellant. The FAA also advised the public authority to develop a framework for maintaining the source of old records made available to IHBAS teams by various family members.

The PRO contended: a) Psychiatric Case Records contain information about emotional disorders, history of suffering of patient. b) Psychiatrist has to maintain Neutrality & Confidentiality with patient and family members. He owes duty of confidentiality as he received information in fiduciary capacity. c) Psychiatric case records cannot be equated with ordinary medical records. Access to full records might provoke serious reactions, including attempt to suicide. d) The Mental Health Act 1987, in India section 13(1) states that Inspector of psychiatric hospital or nursing home is required to keep confidentiality in relation to personal records of patient. As per S. 38 even visitors cannot be allowed to inspect records of patients.

There are two cases which discussed public interest and favoured disclosure. In Surupsingh Hrya Naik vs State Of Maharashtra decided on 23 March, 2007,AIR 2007 Bom 121, a private citizen sought the medical reports of Naik, legislator, who was convicted for contempt of court. It was held that it was in public interest to know why a convict is allowed to stay in an air conditioned comfort of the hospital and there had been intensive questioning about this aspect in the media and the people’s mind.

The medical records of a person are generally confidential as per the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002 framed under the provisions of the Indian Medical Council Act, 1956. In Mr. "X" v. Hospital "Z", case the issue before the Supreme Court was disclosure of information of a patient affected by HIV.  

The person, whose information was disclosed, sought an action in damages, by moving the National Consumer Disputes Redressal Commission which was rejected and then he appealed to the Supreme Court. Dealing with the aspect of privacy, the Court observed: the Right of Privacy is an essential component of right to life envisaged by Article 21. The right, however, is not absolute and may be lawfully restricted for the prevention of crime, disorder or protection of health or morals or protection of rights and freedom of others.

Section 8(1)(j) of RTI Act provides that personal information need not be disclosed unless the larger public interest justifies it.  If the information be personal or would amount to invasion of privacy of the individual, what the Public Information Officer has to satisfy is whether the larger public interest justifies the disclosure. The Bombay High Court said that the Regulations framed under the Indian Medical Council Act, will have to be read with Section 8(1)(j) of the Right to Information Act.

If a spouse is subjected to suffering because of incurable disease of other spouse, it is a ground for divorce. Section 13(i)(v) of the Hindu Marriage Act, 1955 which provides a marriage can be dissolved on the ground that the other party has been incurably of unsound mind, or has been suffering continuously or intermittently from mental disorder of such a kind and to such an extent that the petitioner cannot reasonably be expected to live with the respondent.

This right would positively include the right to be told that a person, with whom she was proposed to be married, was the victim of a deadly disease, which was sexually communicable or that has been incurably of unsound mind or has been suffering continuously or intermittently from mental disorder of such a kind and to such an extent that the petitioner cannot reasonably expected to live with the respondent.

Since "Right to Life" includes right to lead a healthy life so as to enjoy all faculties of the human body in their prime condition, the respondents, by their disclosure that the husband of the appellant has such disease, in any way, either violated the rule of confidentiality or the right of privacy by not disclosing the same. Where two rights which are parts of Article 21- right to privacy and right to healthy life free from injury or disease are conflicting, the public morality and public interest should decide which right to prevail.  

Hence I (as the Central Information Commissioner) have decided that there is a larger public interest that required disclosure of medical records of a patient as mandated under Section 8(1)(j) and directed the respondent authority to furnish the information about the medical records of her husband to the extent she needed to establish the disease he was suffering from, its impact, continuity and incurability or curability, whatever it is, along with necessary certified copies to protect her interest/right to secure divorce under the Hindu Marriage Act, to prevent crime of beating or cruelty against her allegedly being perpetrated or apprehended to have been perpetrated by her husband because of mental illness, shall be provided.

(Based on my decision on 10th April 2015 in Ms JJv. PIO, Institute of Human Behaviour & Allied Sciences, CIC/KY/A/2014/001348-SA)