Angus H. Ferguson

The Evolution of Confidentiality in the United Kingdom and the West

A societys definitions and boundaries of confidentiality are shaped by socioeconomic context.

Ignored Disease or Diagnostic Dustbin? Sudden Infant Death Syndrome in the British Context

Sudden Infant Death Syndrome (SIDS) was defined in 1969 and incorporated into the International Classification of Diseases a decade later. To advocates of SIDS as a diagnosis, medical interest in sudden infant death was long overdue. However, the definition of SIDS lacked positive diagnostic criteria, provoking some to view it as a ‘diagnostic dustbin’ for the disposal of problematic cases where cause of death was unclear. This paper examines the development of medical interest in sudden infant death in Britain during the middle decades of the twentieth century. It highlights the importance of recognising the historicity of SIDS as a diagnosis facilitated by changes in law and medicine over the course of the nineteenth and twentieth centuries. It suggests that SIDS provides a definitive case study of the medicalisation of life and death, and a unique example of an officially recognised disease that had no symptoms, signs, pathology or patients.

The Role of History in Debates Regarding the Boundaries of Medical Confidentiality and Privacy

Medical confidentiality and privacy are often given a long pedigree as core issues in medical ethics that can be traced back to the Hippocratic Oath. However, it is only recently that focused historical work has begun to examine and analyse in greater detail how the boundaries of medical confidentiality and privacy have evolved within a variety of cultural contexts during the modern period. Such research illustrates the ways in which this process has been shaped by a range of issues, individuals, interest groups and events; and been influenced as much by pragmatic concerns as by theoretical arguments. This paper presents a case for the merits of promoting further historical work on these topics. It suggests that greater support for, and recognition of, historical research has a number of potential benefits. These include providing meaningful context to current interdisciplinary discussions of the collection and use of patient information; improving knowledge and understanding of the foundations on which current policy and practice are built; and promoting public engagement and understanding of the evolution of medical confidentiality and privacy as complex public interest issues.

Should a Doctor Tell?: The Evolution of Medical Confidentiality in Britain

Medical confidentiality has long been recognised as a core element of medical ethics, but its boundaries are under constant negotiation. Areas of debate in twenty-first century medicine include the use of patient-identifiable data in research, information sharing across public services, and the implications of advances in genetics. This book provides important historical insight into the modern evolution of medical confidentiality in the UK. It analyses a range of perspectives and considers the broader context as well as the specific details of debates, developments and key precedents. With each chapter focusing on a different issue, the book covers the common law position on medical privilege, the rise of public health and collective welfare measures, legal and public policy perspectives on medical confidentiality and privilege in the first half of the twentieth century, contestations over statutory recognition for medical privilege and Crown privilege. It concludes with an overview of twentieth century developments. Bringing fresh insights to oft-cited cases and demonstrating a better understanding of the boundaries of medical confidentiality, the book discusses the role of important interest groups such as the judiciary, Ministry of Health and professional medical bodies. It will be directly relevant for people working or studying in the field of medical law as well as those with an interest in the interaction of law, medicine and ethics.