Letters to the editor - August 5, 2025

Healthcare professionals’ duty to report

Mark Said of Msida writes:

I refer to the health minister’s call for a secrecy law change following a woman’s abortion conviction. It is apt at this point in time to clarify the legal obligations of healthcare professionals.

It relates to how health professionals should respond in a situation where they become aware that a woman has sought an abortion outside the current legal framework. Must they report to the police? May they not report to the police (for example, if they have a personal view that abortion is not morally wrong and that it should be decriminalised)? Or, if they do report to the police, might the health professional be the one who ends up in trouble?

Confidentiality has been thought to be vital to the doctor-patient relationship for centuries. Photo: Shutterstock.com

The central ethical issue at stake here is not, in fact, the morality of abortion. Rather, the key issue is about medical confidentiality and when health professionals are justified in violating their strong obligations to safeguard the patient’s medical details.

Confidentiality has been thought to be vital to the doctor-patient relationship for centuries. For doctors to be able to help patients, they need the patient to provide full details of their symptoms and how they have arisen.

That will sometimes include very private details – say, of sexual relationships and function – which the patient will only divulge if they can be assured the doctor will keep them strictly secret.

In more recent decades, confidentiality has also been justified in terms of a more fundamental right of the patient to privacy and autonomy. That right seems particularly vital when it comes to reproductive healthcare.

Because it is so important, modern codes of practice for health professionals allow confidentiality to be breached only in truly exceptional circumstances. That could include notification of a serious infectious disease or prevention of terrorism. But it does not, in most circumstances, include reporting that a patient has committed a crime.

Healthcare professionals must constantly keep in mind the potential consequences of breaching patient confidentiality.

Providing information, without her permission, about a woman’s pregnancy and reproductive choices is a grave threat to patient trust and risks serious harm to vulnerable patients.

So, yes, the health minister is right in calling for an amendment to the secrecy law that, without any need to decriminalise or amend our abortion prohibition law, would allay our healthcare professionals’ concerns that they might find themselves having to answer awkward questions in front of their regulatory bodies.