1. One of the most important legal obligations owed by a physician to a patient is the protection of confidences revealed by the patient to the physician. Article 458 of the Criminal Code lays upon a physician a legal obligation not to disclose confidential information concerning a patient which he learns in the course of his professional practice.
   The doctor’s obligation of non-disclosure applies not only to information acquired directly from the patient, but also to information concerning the patient which the doctor learns from other sources in his character as the patient’s doctor.
2. The duty of medical secrecy is not limited to physicians who are in a relationship ad sanandum with their patients. A physician who medically investigates a person at the request of a third party, e.g. an employer or insurance company, is also bound by the duty to medical secrecy, although he may inform his principal (opdrachtgever) within the limits of his mission.
3. Article 458 of the Criminal Code has a large field of application in that it not only applies to physicians but to everyone who in the course of his professional practice is being informed of confidential information. Therefore, it is generally accepted that not only physicians but also nursing and paramedical personnel are bound to a duty of secrecy. Because all the members of a medical team are obliged to respect the confidentiality of the patient’s information, one accepts that this information may circulate within the team. This is often called the ‘shared medical secret’.
4. Article 458 of the Criminal Code provides for two exceptions to the duty of professional secrecy of a physician. There is no offence if a physician discloses confidential information during a testimony before a court or before a Parliamentary Committee, neither when a law obliges him to divulge such information.
5. Some jurisprudence accepts that a physician can be released from the obligation to keep the confidence with the express or implicit consent of the patient. The Belgian jurisprudence remains divided regarding the validity of the consent of the patient in this respect. According to the Court of Cassation, a physician cannot be released from the duty to secrecy by the circumstance that the patient has consented to the disclosure of confidential information. In the Court of Cassation’s opinion the duty of medical secrecy is of public order; thus it is not to the disposition of the patient. This opinion is completely in accordance with Article 64 of the code of professional ethics of the Order of Physicians. Lower tribunals and courts of appeal, however, have recognized that the consent of the patient may release a physician of his duty of medical secrecy. And the great majority of legal writers defend the same point of view. Important to note in this respect is that the former Prosecutor General to the Court of Cassation, F. Dumon, also has acknowledged that the consent or request of the patient enables a physician to disclose confidential information to a third party.

Extra information

a) Information on the Exceptions to the obligation of Medical Secrecy
b) Information on the Notification of Criminal Acts
c) Information on the Deliverance of Medical Certificates to Third Parties

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