Preserving medical confidentiality in Brazilian criminal investigation cases: a narrative review of the principles of bioethics

• Type: Another Publication in an International Scientific Journal
• Date: 2025

Authors

Zarpellon, HM (Author) Other; Bianchi, F (Author) Other; Fürst, H (Author) Other; Rui Nunes (Author) FMUP

Journal

Title: Clinics

Vol. 80

ISSN: 1807-5932

Publisher: Universidade de São Paulo

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 0 Citations

Other information

Authenticus ID: P-019-XZG

DOI: 10.1016/j.clinsp.2025.100740

Abstract (EN): Medical confidentiality is a fundamental element of the doctor-patient relationship, ensuring a secure environment for sharing sensitive information. This narrative review examines the ethical and legal challenges faced by physicians in Brazil when balancing professional secrecy with the legal duty to report, particularly in the context of criminal investigations. Grounded in the core bioethical principles of autonomy, beneficence, nonmaleficence, and justice, the study analyzes Brazilian constitutional and infra-constitutional norms, including the Penal Code, the Code of Criminal Procedure, and the Code of Medical Ethics. The methodology is qualitative and descriptive-analytical, based on thematic and interpretive analysis of legal documents, court decisions, professional guidelines, and ethical frameworks. Comparative perspectives from Portugal, the United States, and international declarations (e.g., WMA Geneva Declaration, UNESCO Bioethics Declaration) are also included to situate Brazil's legal approach in a global bioethical context. The study highlights the risks of breaching confidentiality without just cause, emphasizing real-life cases involving abortion, HIV disclosure, and unlawful access to patient data. Findings indicate that while breaches may be justified in exceptional situations - such as imminent risk to third parties - confidentiality must remain the standard. The article concludes that ethically informed and legally compliant medical practice requires a careful balance between respecting patient privacy and fulfilling public health and judicial responsibilities. Upholding confidentiality strengthens the therapeutic alliance, protects vulnerable individuals, and ensures alignment with both national law and international bioethical standards.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7