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J Med Ethics 2008;34:e6 doi:10.1136/jme.2008.024794
  • Clinical ethics
    • Electronic pages

Contractual obligations and the sharing of confidential health information in sport

  1. L Anderson
  1. Ms L Anderson, Bioethics Centre, University of Otago, PO Box 913, Dunedin, New Zealand; lynley.anderson{at}stonebow.otago.ac.nz
  • Received 10 February 2008
  • Revised 26 May 2008
  • Accepted 10 June 2008

Abstract

As an employee, a sports doctor has obligations to their employer, but also professional and widely accepted obligations of a doctor to the patient (in this case the individual team member). The conflict is evident when sports doctors are asked by an athlete to keep personal health information confidential from the coach and team management, and yet both doctor and athlete have employment contracts specifying that such information shall be shared. Recent research in New Zealand shows that despite the presence of an employment contract, there appears to be a wide range of behaviours among sports doctors when an athlete requests that information about them be kept from team management. Many seem willing to honour requests to keep health information about the athlete confidential, thereby being in breach of the employment contract, while others insist on informing team management against the wishes of the athlete. There are a number of potential solutions to this dilemma from forcing doctors to meet their contractual obligations, to limiting the expectations of the employment contract. This paper suggests that at times it may be appropriate to do both, making the position of the doctor clearer and supporting the ability of this group to resist pressure by coaches and management through having a robust code of ethics.

Footnotes

  • Competing interests: The author has been involved in rewriting the Australasian College of Sports Physician’s Code of Ethics.

  • Funding: The author acknowledges the University of Otago Research Grant for this project.

  • Ethics approval: This study was approved by the University of Otago Ethics Committee.

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