| Acknowledgements | p. xi |
| Table of Cases | p. xiii |
| Table of Legislation | p. xxv |
| List of Abbreviations | p. xxxi |
| Introduction | p. 1 |
| Ethical Considerations | p. 7 |
| Main schools of medical ethics | p. 8 |
| Utilitarianism | p. 8 |
| Deontological theories | p. 9 |
| A duty-based approach | p. 9 |
| A rights-based approach | p. 10 |
| A principle-based approach | p. 11 |
| Autonomy, privacy and confidentiality | p. 12 |
| Principle of autonomy | p. 12 |
| Privacy | p. 13 |
| Medical confidentiality | p. 16 |
| Conflicts of interests in the context of criminal prosecution and crime prevention | p. 20 |
| Strict confidentiality? | p. 20 |
| Medical confidentiality and the administration of criminal justice | p. 21 |
| Utilitarian approaches | p. 22 |
| Deontological approaches | p. 25 |
| Medical confidentiality and the interests of third parties | p. 28 |
| Crime prevention | p. 28 |
| Defence rights | p. 31 |
| Conclusion | p. 31 |
| European Law | p. 34 |
| Protection of medical confidentiality | p. 34 |
| European Convention on Human Rights | p. 34 |
| European Convention on Human Rights and Biomedicine | p. 37 |
| Data Protection Directive 95/46/EC | p. 37 |
| European Charter of Fundamental Rights | p. 38 |
| Disclosure in the context of crime prevention and criminal prosecution | p. 38 |
| Criminal prosecution | p. 39 |
| Conflicting defence rights | p. 42 |
| Crime prevention | p. 44 |
| Summary | p. 46 |
| French Law | p. 47 |
| Protection of medical confidentiality | p. 47 |
| Medical confidentiality as a fundamental right | |
| Constitutional right | p. 47 |
| European Convention on Human Rights | p. 49 |
| Protection under criminal law | p. 50 |
| Protection under private law | p. 57 |
| Article 9 of the Civil Code | p. 57 |
| Obligation under contract and tort law | p. 58 |
| Professional obligation | p. 59 |
| Summary | p. 59 |
| Disclosure in the context of crime prevention and criminal prosecution | p. 60 |
| General and absolute obligation of medical confidentiality | p. 60 |
| Obligation to give testimony | p. 62 |
| Defence rights of the physician | p. 63 |
| Effects of the patient's consent | p. 68 |
| Obligation to disclose certain information | p. 74 |
| Crime prevention | p. 74 |
| Child abuse | p. 76 |
| Protection of the innocent | p. 78 |
| Admissibility of the physician's testimony | p. 80 |
| Search for and seizure of medical records | p. 80 |
| Summary and conclusion | p. 87 |
| German Law | p. 90 |
| Protection of medical confidentiality | p. 90 |
| Medical confidentiality as a fundamental right | p. 90 |
| Protection under the German Constitution | p. 90 |
| European Convention on Human Rights | p. 95 |
| Protection under criminal law | p. 96 |
| Protection under contract and tort law | p. 99 |
| Professional obligation | p. 100 |
| Summary | p. 101 |
| Disclosure in the context of crime prevention and criminal prosecution | p. 102 |
| A physician's testimony in criminal court | p. 102 |
| Refusal to testify - right or obligation? | p. 105 |
| Effects of the patient's consent | p. 108 |
| Disclosure for the purpose of criminal prosecution | p. 109 |
| Testimony to establish the innocence of an accused | p. 111 |
| Crime prevention | p. 114 |
| Confidential material exempt from search and seizure | p. 117 |
| Protection of the accused | p. 119 |
| Custody requirement | p. 123 |
| Effect of the patient's consent | p. 124 |
| The physician's right to submit confidential material | p. 125 |
| Summary and conclusion | p. 125 |
| English Law | p. 127 |
| Protection of medical confidentiality | p. 127 |
| Medical confidentiality as a fundamental right | p. 127 |
| Contractual obligation | p. 129 |
| Equitable duty | p. 129 |
| Obligation of confidence | p. 130 |
| Confidential quality of the information | p. 136 |
| Breach of duty | p. 145 |
| Detriment | p. 147 |
| Remedies | p. 148 |
| Purpose behind equitable protection of medical confidentiality | p. 149 |
| Statutory obligations and criminal offences | p. 154 |
| Professional obligation | p. 155 |
| Summary | p. 156 |
| Disclosure in the context of crime prevention and criminal prosecution | p. 157 |
| State access to confidential medical information | p. 158 |
| Medical privilege in criminal court | p. 158 |
| Legal professional privilege | p. 170 |
| Police access to confidential medical information | p. 172 |
| Definition of excluded material | p. 173 |
| Application for an order giving access to excluded material | p. 174 |
| Access to excluded material without court order | p. 175 |
| Voluntary disclosure by the physician | p. 176 |
| Submission of medical records to the police | p. 177 |
| Disclosure for the purpose of criminal prosecution | p. 179 |
| Disclosure to assist the defence | p. 184 |
| Disclosure for the purpose of crime prevention | p. 188 |
| Summary and conclusion | p. 195 |
| American Law | p. 198 |
| Protection of medical confidentiality | p. 198 |
| Constitutional privacy protection | p. 198 |
| Fifth Amendment (Self-Incrimination Clause) | p. 199 |
| Fourth Amendment (Unreasonable search and seizure) | p. 201 |
| Fourteenth Amendment (Substantive due process) | p. 204 |
| Privacy protection under State constitutions | p. 212 |
| Statutory obligations | p. 213 |
| Privilege statutes | p. 213 |
| Licensing statutes | p. 223 |
| Private law actions for breach of medical confidentiality | p. 223 |
| Obligation of medical confidentiality | p. 223 |
| Obligation under contract law | p. 224 |
| Action under tort law | p. 225 |
| Professional obligation | p. 227 |
| Summary | p. 227 |
| Disclosure in the context of crime prevention and criminal prosecution | p. 229 |
| Federal law | p. 229 |
| State law | p. 235 |
| Reasons behind the recognition of privilege | p. 235 |
| Limitations to medical privilege | p. 240 |
| General considerations | p. 240 |
| Interests in criminal prosecution and the administration of justice | p. 241 |
| A special problem: child abuse | p. 249 |
| A special problem: drunk driving | p. 250 |
| Investigations against the physician | p. 251 |
| Conflicting defence rights | p. 253 |
| Crime prevention | p. 266 |
| Summary and conclusion | p. 270 |
| Comparative Conclusions | p. 274 |
| Protection of medical confidentiality | p. 275 |
| Constitutional protection | p. 275 |
| Scope and means of protection | p. 279 |
| Differences between common law and civil law approaches | p. 283 |
| Disclosure in the context of crime prevention and criminal prosecution | p. 284 |
| Medical privilege in criminal courts | p. 284 |
| Recognition of medical privilege | p. 284 |
| Medical privilege only for minor offences? | p. 293 |
| Psychotherapist-patient privilege | p. 297 |
| Medical privilege at the discretion of the physician? | p. 298 |
| Effect of the patient's consent | p. 301 |
| Medical records | p. 302 |
| Prosecution of the physician | p. 304 |
| Conclusion | p. 305 |
| Defence rights | p. 306 |
| Defence rights of the patient | p. 306 |
| Defence rights of third parties | p. 306 |
| Defence rights of the physician | p. 313 |
| Protection of the innocent | p. 314 |
| Conclusion | p. 317 |
| Crime prevention | p. 318 |
| Obligation to disclose | p. 318 |
| Justification of disclosure | p. 319 |
| Balancing of interests | p. 321 |
| Weight of the conflicting interests | p. 322 |
| Danger, imminence of the risk and general risks of life | p. 323 |
| Avoidability of the risk | p. 326 |
| Proportionality of disclosure | p. 327 |
| Conclusion | p. 329 |
| Concluding remarks | p. 330 |
| Bibliography | p. 333 |
| Index | p. 343 |
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