Disclosure of medical records breached patient’s human rights – Strasbourg

30 April 2014 by Rosalind English

L.H. v Latvia [2014] ECHR 453 (29 April 2014) – read judgment

The release of confidential patient details to a state medical institution in the course of her negotiations with a hospital over a lawsuit was an unjustified interference with her right to respect for private life under Article 8.

Background

In 1997 the applicant gave birth at a state hospital in Cēsis. Caesarean section was used, with the applicant’s consent, because uterine rupture had occurred during labour. In the course of that surgery the surgeon performed tubal ligation (surgical contraception) without the applicant’s consent.

In 2005, after her attempt to achieve an out-of-court settlement with the hospital had failed, the applicant initiated civil proceedings against the hospital, seeking to recover damages for the unauthorised tubal ligation. In December of 2006 her claim was upheld and she was awarded compensation in the amount of 10,000 Latvian lati for the unlawful sterilisation.

In the meantime, in February 2004, the Inspectorate of Quality Control for Medical Care and Fitness for Work (“the MADEKKI”), on request by the district hospital’s director, initiated an administrative inquiry concerning the gynaecological and childbirth assistance provided to the applicant from 1996 to 2003. The MADEKKI received medical files from three medical institutions and, in May 2004, issued a report containing sensitive medical details, and the summary of the conclusions was sent to the hospital director. The applicant’s lawyer lodged a claim before the administrative courts, complaining that the inquiry had been unlawful, in particular since its essential purpose had been to help the hospital to gather evidence for the impending litigation, which was outside the MADEKKI’s remit. The  claim was rejected by the Administrative District Court in a decision eventually upheld by the Senate of the Supreme Court in February 2007.

In this petition to Strasbourg, Ms H. complained that the MADEKKI, by collecting her personal medical data, had violated her rights under Article 8 (right to respect for private and family life). The Court found that her rights had indeed been violated and awarded her 11,000 euros by way of “just satisfaction”, or non-pecuniary damages.

Reasoning behind the Court’s judgement 

The Court accepted the respondent government’s argument that the MADEKKI was authorised to collect information and documents from medical institutions relating to questions within its field of competence. But the Senate of the Supreme Court did not explain which of its functions the MADEKKI had been carrying out or what public interest it had been pursuing when it issued a report on the legality of the applicant’s treatment. Accordingly the Senate did not and could not examine the proportionality of the interference with the applicant’s right to respect for her private life against any public interest. Furthermore, under domestic law MADEKKI was under no legal obligation to take decisions concerning the processing of medical data in such a way as to take the data subject’s views into account, whether simply by asking for and potentially receiving the data subject’s consent or by other means.

The Court reiterated that the protection of personal data, not least medical data, is of fundamental importance to a person’s enjoyment of the right to respect for his or her private life as guaranteed by Article 8 of the Convention:

Respecting the confidentiality of health data is a vital principle in the legal systems of all the Contracting Parties to the Convention. It is crucial not only to respect the sense of privacy of a patient but also to preserve confidence in the medical profession and in the health services in general (see Z v. Finland, cited above, § 95, and Varapnickaitė-Mažylienė v. Lithuania, no. 20376/05, § 44, 17 January 2012). [para 56]

The Court found it significant that the applicable law did not limit in any way the scope of private data that could be collected by the MADEKKI. In the present case the MADEKKI collected the applicant’s medical data concerning a period spanning seven years, starting one year before the disputed tubal ligation and ending six years after it.  The relevance and sufficiency of the reasons for collecting information about the applicant that was not directly related to the procedures carried out at the Cēsis hospital in 1997 appear not to have been examined at any stage of the domestic procedure.

In the light of these considerations the Court could not find that the applicable Latvian law was formulated with sufficient precision and afforded adequate legal protection against arbitrariness. Neither did it indicate with sufficient clarity the scope of discretion conferred on the competent authorities and the manner of its exercise.

The Court accordingly concluded that the interference with the applicant’s right to respect for her private life was not in accordance with the law within the meaning of Article 8(2) of the Convention. Consequently there has been a violation of Article 8.

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