Explanation of Civil and Criminal Liability of the Therapist in Breach of Medical Confidentiality

Abstract

Medical confidentiality, as a fundamental pillar of the therapist–patient relationship, is not only an ethical obligation but also a legal duty, the violation of which can impose severe civil and criminal liabilities on the therapist. From the perspective of civil liability, by disclosing the patient’s secrets, the therapist commits a professional fault (Article 1 of the Civil Liability Act) and is obliged to compensate both material damages (such as loss of employment opportunities) and moral damages (harm to reputation and privacy). Judicial practice in Iran, as reflected in rulings such as Decision No. 722 of the Supreme Court (2019), demonstrates that the mere existence of a causal relationship between disclosure and harm, even without intentional fault, suffices for the therapist’s conviction. On the other hand, the therapist’s criminal liability is prosecutable under the heading of “disclosure of secrets” (Article 648 of the Islamic Penal Code), for which the punishment prescribed is up to one year of imprisonment and a monetary fine. Although this article is general, in cases such as disclosure of information regarding patients with HIV or psychological disorders, by invoking “disturbance of public opinion” (Article 609 of the Islamic Penal Code), the punishment is aggravated. The ambiguity in the precise definition of “medical secrets” and the absence of independent supervisory mechanisms (such as a medical ethics oversight body) constitute the main challenges in achieving justice for patients. These legal and institutional gaps have resulted in many violations, especially in cyberspace (pursuant to Article 16 of the Cybercrime Act), remaining without consequence. Therefore, a revision of existing laws and the strengthening of supervisory institutions are essential steps for guaranteeing patients’ rights and balancing the duties of therapists.