THE RIGHT TO HEALTH IN PRISON: RESULTS OF A NATIONWIDE SURVEY AND REPORT communicate their recommendations to the patient as best they can, this was not seen to be done as there was only one doctor available to approximately 1500 prisoners at a particular prison109 during the Commission’s visit. Medical records and Confidentiality 4.16 A prisoner’s health care records (i.e. medical records) should be compiled, maintained, and retained in accordance with accepted health care practice and standards. Medical staff and doctors working with prisoners have a special duty to ensure that the doctor-patient relationship is preserved, and that doctors are not seen simply as part of the prison administration. Prison medical staff must be seen as responsible for ensuring the confidentiality of prisoners’ medical files, which may contain sensitive information.110 4.17 Further, and in accordance with the World Medical Association International Code of Medical Ethics,111 “a physician shall respect a patient’s right to confidentiality. It is ethical to disclose confidential information when the patient consents to it or when there is a real and imminent threat of harm to the patient or to others and this threat can be only removed by a breach of confidentiality.”112 4.18 During its visits, the Commission observed that the medical records of prisoners were sometimes openly shared, possibly in breach of the strict confidentiality rules applicable to doctors and their patients.113 Nevertheless, the Commission explains that if the doctor warrants medical information of a prisoner to be disclosed, for example for the provision of health care; to disclose to the prison officials the nature of injuries to a prisoner that has been assaulted by fellow prisoners:114 or for the health and safety of the prisoner himself or other prisoners, the doctor may exercise his/her discretion to do so. However, the medical records of prisoners shall not be openly available and accessible to anyone without any safeguards in Kajang Women’s Prison Health and human rights in prisons, 2001 by Hernán Reyes MD, International Committee of the Red Cross: Extract from “HIV in Prisons”. Accessed via https://www.icrc.org/eng/resources/documents/misc/59n8yx.htm#a10 on 18/2/2016. 111 Adopted by the 3rd General Assembly of the World Medical Association, London, England, October 1949 and amended by the 22nd World Medical Assembly, Sydney, Australia, August 1968 and the 35th World Medical Assembly, Venice, Italy, October 1983 and the 57th WMA General Assembly, Pilanesberg, South Africa, October 2006. Accessed via http://www. wma.net/en/30publications/10policies/c8/ on 19/2/2016 112 Ibid 113 The World Health Organization Guidelines on HIV infection and AIDS in prisons (1999) in paragraph 31 recommends that information on the health status and medical treatment of prisoners is confidential and should be recorded in files available only to health personnel. Health personnel may provide prison managers of judicial authorities with information that will assist in the treatment and care of the patient, if the prisoner consents. Accessed via http://www.unaids.org/sites/default/files/ media_asset/jc277-who-guidel-prisons_en_3.pdf on 19/2/2016. 114 CPT Standards 2002 (rev. 2011); CPT/Inf (2011)33; (2011)24; (2012)17; (2012)34. Accessed via http://www.cpt.coe.int/en/ annual/rep-22.pdf on 19/2/2016 109 110 66