Dr. Tokugha Yepthomi v Apollo Hospital Enterprises (1998)

Confidentiality is a duty, not an absolute. This is the case that fixes the exception: where silence would endanger an identifiable person's life, the duty yields. It is the authority for every problem in which a doctor learns something about one patient that another person needs to know in order to protect herself.

The appellant, himself a doctor, was found to be HIV-positive at Apollo Hospital in June 1995. In August 1995 he became engaged to be married, and his HIV-positive status was disclosed to his fiancée. He sued the hospital for damages, contending that the information was secret and had to be kept confidential under medical ethics.

The Supreme Court rejected the contention. The disclosure helped preserve the health of another individual and was in the interest of society. A prospective spouse who apprehends that the other is suffering from the disease has a right to seek information about that illness from the hospital, and that right is part of the right to life.

The Court did not treat confidentiality as displaced by the seriousness of the diagnosis; it weighed the interest that the disclosure serves. The fiancée was an identifiable person facing a specific risk to her own life, and her right to life includes the right to the information she needs to avoid that risk. Confidentiality protects the patient's interest; it does not extend to shielding him while another person is exposed to a danger only he knows of. So the duty yields — and it yields only so far as the danger requires.

That last limit is what makes the case workable in practice: the exception is measured by the risk, which means the doctor discloses only what is necessary, and only to the person at risk.

This is the first case on confidentiality and its exceptions. Structure: the duty and its sources in the ethical code → the recognised exceptions → Tokugha Yepthomi for the identifiable-risk exception → contrast X v Y, where two hospital doctors with AIDS were exposed by a newspaper which had paid hospital employees for the information; there the employees were held to be under a legal duty not to disclose, publication was restrained, and the newspaper was fined for contempt. The difference between the two is the interest the disclosure serves, not the sensitivity of the information.

In a problem where a patient with a communicable disease is about to marry and a doctor tells the intended spouse, the answer is short: disclosure to a prospective spouse to protect her life is justified; the doctor must disclose only what is necessary and only to the person at risk; the patient's suit fails.

What it does not decide: it does not permit disclosure to the world, to an employer, or to relatives who face no risk; it does not decide what a doctor must do if the patient agrees to tell the other person himself; and it does not settle the quite different question of whether the doctor has a positive duty to warn, as against a liberty to do so.

A caution on the citation. This paper carries the case under this name and this report reference. The reported decision is also known by a different case title in the official reports, and there is a later follow-up decision; neither is covered here, so do not attribute holdings to them.