Even if confidentiality and the obligation of professional secrecy are extensive, there are some cases when confidentiality can be broken without the consent of the patient. Those are
- when a court, prosecutor, police, law enforcement, or tax authority demands to know if a certain person is being treated at a health care institution.
- when the National Board of Health and Welfare requires the information for their activities.
- when the Swedish Transport Agency needs the information to review someone's suitability for having a driver's license, a tractor license or a taxi driver's licence.
- when the information is needed for reviewing if a student should be suspended from studying at university.
- when the information is needed in a forensic investigation.
Regarding suspicion of a crime that is severe enough to warrant at least one year in prison, health care professionals have the right to break confidentiality by reporting the crime to the police, and answer the questions made by the police and prosecuting authorities. Examples of such crimes are murder, rape, and aggravated assault. There some traffic offences with milder penalties, like driving under the influence, which health care professionals are entitled to report.
Special exceptions for children
Exceptions to the obligation of professional secrecy are made when it comes to children, if health care professionals suspect that the child is being subjected to a crime, like assault or sexual abuse.
If health care professionals suspect that a child is being harmed, they should report their suspicions to social services, who then conduct an investigation and later report to the police if necessary. The same thing applies if there is an investigation under way regarding a minor's need of protection. Then, healthcare professionals are obligated to give out information that can be of value to the investigation.
The Swedish Social Insurance Agency and insurance companies
Patients decide themselves if the health and medical care system are permitted to release information regarding current or previous diseases and treatments. But if you are sick and you apply for financial compensation at the Swedish Social Insurance Agency, health care professionals are entitled to give out the information required to assess whether the application is eligible for compensation.
This also applies when you are injured or catch a disease and want to be compensated by an insurance company. If applying for financial compensation, the insurance company is entitled to study the information needed to make a correct assessment regarding your right to receive compensation.
As regards small children, the legal caregiver decides whether or not information is to be handed out. When the child gets older, and is considered to be mature enough in this regard, he or she is entitled to decide alone whether or not healthcare professionals are allowed to release information, and to whom. Thus, there is no specific age limit as to when a child is entitled to decide alone; it is determined in each individual case. In some cases, legal caretakers are not allowed to be informed of the child's health condition.
Breach of Confidentiality
Even if there are some situations when healthcare professionals are allowed or obligated by law to break the rules of confidentiality, those cases are exceptions. The general idea is that being bound by professional secrecy should ensure the protection of the patient.
If a patient suspects that a healthcare professional is in breach of confidentiality, he or she can report it to the police or social services. It can lead to that person being prosecuted and sentenced.