Medicine—Doctor/patient relationship—Medical records—Patient's right to access—Contractual right—Doctor's duty to act in patient's 'best interests' with utmost good faith and loyalty—Patient's proprietary right or interest in information contained in records—Whether doctor under fiduciary duty to grant access—'Right to know'.
Headnote
Hearing
CANBERRA, 21 November 1995 #DATE 6:9:1996, CANBERRA
Counsel for the Appellant P K Cashman with V Culkoff
Solicitors for the Appellant Cashman and Partners
Counsel for the Respondent A R Emmett QC with J P A Durack
Solicitors for the Respondent E H Pike
Orders
Appeal dismissed with costs. Notice: This copy of the Court's Reasons for Judgment is subject to formal revision prior to publication in the Commonwealth Law Reports.
Decisions
BRENNAN CJ. The circumstances which give rise to the issues in this appeal are set out in other judgments. The appellant, who has been a patient of the respondent medical practitioner, claims a legal right to reasonable access to the records kept by the respondent with respect to the appellant and a right to inspect and/or copy those records. Subject to certain admitted exceptions, the appellant submits that that right is enforceable by declaration and injunction. The right is submitted to be based variously on contract, property and fiduciary duty. In my view, none of these bases gives any support to the appellant's claim. I state my reasons.
Contract 2. In the present case, there was no formal contract between the appellant and the respondent. No more appears than that the appellant consulted the respondent as a medical practitioner and he provided medical services accordingly.
3. In the absence of special contract between a doctor and a patient, the doctor undertakes by the contract between them to advise and treat the patient with reasonable skill and care. The consideration for the undertaking may be either a payment, or promise of payment, of reward or submission by the patient, or an undertaking by the patient to submit, to the treatment proposed. A duty, similar to the duty binding on the doctor by contract, is imposed on the doctor by the law of torts. The advice and treatment required to fulfil either duty depends on the history and condition of the patient, the facilities available and all the other circumstances of the case.
4. The provision of advice and treatment with reasonable skill and care may not exhaust the duty of the doctor. Unless the contract between doctor and patient is especially restricted, the doctor's obligation is to maintain or improve the health of the patient generally and to use reasonable skill and care in doing so, even though the advice or treatment required on a particular occasion is in a specialist field or is to be provided only on that occasion or for a limited time. The patient may be thought of as made of many parts some one of which may need…
Grounds of appeal
[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.
[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.
[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.
Consideration
[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.
[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.
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Details
AGLC
Breen v Williams [1996] HCA 57
Case
[1996] HCA 57
Decision Date
CaseChat Overview and Summary
The High Court of Australia considered an appeal by Mr. Breen against Dr. Williams concerning Mr. Breen's access to his medical records. Mr. Breen sought access to these records, which were held by Dr. Williams, a medical practitioner. The dispute centred on whether Mr. Breen had a legal right to obtain these records.
The central legal issues before the High Court were whether a patient possesses a proprietary right in the information contained within their medical records, whether a doctor owes a fiduciary duty to a patient to grant access to those records, and whether a doctor's duty to act in a patient's best interests, with utmost good faith and loyalty, extends to providing access to their medical records. The Court also considered the concept of a patient's "right to know" in this context.
The High Court, by majority, dismissed Mr. Breen's appeal. The Court reasoned that while a doctor has a duty to act in a patient's best interests, this duty does not create a proprietary right for the patient in the information within the medical records, nor does it impose a fiduciary duty on the doctor to grant access. The Court found that the relationship between doctor and patient, while involving trust and good faith, does not give rise to a fiduciary duty in the sense that would compel a doctor to provide access to the records. The appeal was dismissed with costs.