IN THE SUPREME COURT OF THE
STATE OF GEORGIA
CASE NO. S99A1490
REBECCA LYNN KING,
Appellant,
v.
STATE OF GEORGIA,
Appellee.

BRIEF OF AMICUS CURIAE

At the request of this Honorable Court, the Georgia Trial Lawyers Association respectfully submits the following brief as amicus curiae.

SUMMARY OF THE ARGUMENT

1. OCGA § 24-9-40 should not be construed to authorize subpoenas for the production of medical information. Instead, by conditioning the medical provider’s immunity from liability for disclosure upon the submission of an “appropriate” subpoena, the General Assembly has intended that external standards of appropriateness apply to such subpoenas. The best, well-tested, external standard is the procedure for disclosure of medical information by means of the request for production of documents to a third-party under OCGA § 9-11-34(c)(2), which was enacted in the same statute with the current version of OCGA § 24-9-40(a).

2. As to the constitutional issues, each patient has a right to privacy in his or her personal medical information.

3. The patient’s privacy right is not absolute. Instead, the right to privacy is subordinate to the right of an adversary in litigation to obtain information relevant to the claims and defenses of the parties.

4. The right of an adversary to obtain relevant information is, however, limited by procedural due process protections against unqualified disclosure. As a consequence, all methods of investigation, whether formal or informal, designed to elicit personal medical information must afford the patient reasonable notice and a reasonable opportunity to object and be heard before the disclosure of medical information occurs.

5. GTLA submits that, in construing OCGA § 24-9-40 and in resolving the issues in this case, the Court should adopt a procedure with at least the due process protections afforded by OCGA § 9-11-34(c)(2).

ARGUMENT AND CITATION OF AUTHORITY

I.  THE LEGISLATURE’S INTENTION TO SHIELD MEDICAL RECORDS PROVIDERS FROM LIABILITY FOR PRODUCING RECORDS PURSUANT TO AN APPROPRIATE SUBPOENA WILL BE FURTHERED BY INTERPRETING OCGA § 24-9-40(a) TO REQUIRE NOTICE AND AN OPPORTUNITY TO OBJECT.

This amicus submits that construction of OCGA § 24-9-40(a) as authorizing the issuance of subpoenas is erroneous. By its terms,[1] OCGA § 24-9-40(a) does not grant to the State –- or any party to litigation, whether civil or criminal -- the authority to use its provisions as an investigative tool to subpoena medical records. No language in the statute authorizes the issuance of subpoenas, and if the statute were nevertheless construed to authorize issuance of subpoenas for medical records, the statute would authorize the issuance of subpoenas to all litigants, to the state and to criminal defendants, and to civil plaintiffs and defendants, on an equal basis. Moreover, the statutory qualification that records may be turned over upon an “appropriate” court order or subpoena calls for some standard of appropriateness that is external to the statute, which does not define the term. If the statute authorized subpoenas, then any subpoena issued thereunder would be “appropriate,” and the word “appropriate” would be mere surplusage.

Courts should not so interpret a statute as to make parts of it surplusage unless no other construction is reasonably possible. All words of the Legislature, however numerous, ought to be preserved, and effect given to the whole, if it can be done.

Fulton-DeKalb Hosp. Auth. v. Gaither, 241 Ga. 572, 574 (1978). For these reasons, the statute should not be construed to authorize the issuance of subpoenas.

Instead, this Court should construe the statute in view of its evident intent to establish the circumstances and conditions under which “medical information” may be released with immunity from tort claims for invasion of privacy. The General Assembly called for a subpoena for medical records to be “appropriate.” Unless a clear standard for “appropriate” subpoenas applies, the medical records provider will be saddled with the burden of determining whether or not a subpoena in a particular case is “appropriate.” Not only will this subject the medical records provider with an unnecessary burden of reviewing and determining whether or not a subpoena is “appropriate,” but it will also subject the medical records provider to liability if their decision is incorrect. Both results contradict the evident intent of the legislature to relieve a medical provider of the threat of litigation for unauthorized disclosure.

Fortunately, the General Assembly’s standard of “appropriateness” is clear from the legislative context: OCGA § 24-9-40(a) reached its present shape in the same bill that enacted OCGA § 9-11-34(c)(2), 1986 Ga. Laws 1277, §§ 1, 3. In the latter statute, discussed in more detail in Section V of this brief, patients are given ten days notice of an adversary’s requests for production of medical records so that they may object and seek a judicial determination before disclosure. A purpose of the act was to “revise ... certain procedures to secure documents from otherwise privileged sources.” Id., 1277.

Allowing patients notice and an opportunity to seek judicial review of a subpoena under OCGA § 24-9-40(a) in a manner similar to OCGA § 9-11-34(c)(2) will further the legislative intent to protect a medical records provider from liability for producing documents pursuant to an “appropriate” subpoena. Such a procedure will take the burden of reviewing a subpoena for appropriateness off of the medical records provider and place it on the patient, which furthers the goal of OCGA § 24-9-40(a) in protecting a medical records provider from liability. The medical records provider will have no liability for disclosure because failure of the patient to object will be deemed a waiver of any claim against the medical records holder.

II.  EACH PATIENT HAS A RIGHT TO PRIVACY IN THE PATIENT’S PERSONAL MEDICAL INFORMATION.

An individual’s medical information is a matter of personal privacy that is within the concept of “liberty” in 1983 Ga. Const. Art. I, Sec. I, Par. I, the due process provision of Georgia’s Bill of Rights. This has been recognized for over a century. The right of privacy includes information about one’s medical condition, even if that information is in the possession of a hospital or doctor. It includes the patient’s entire medical record, not just communications from the patient.

Georgia has recognized a right of privacy since Pavesich v. New England Life Ins. Co., 122 Ga. 190 (1904) (recognizing the right of privacy and finding that publication of a person’s picture for commercial purposes violates that right). The right derives from natural law, a right that is reserved and not surrendered when one leaves the state of nature to enter upon civil society. Id., 194. Though derived from nature, it is recognized by municipal law and guaranteed by the constitutions of the United States and Georgia in the prohibition of deprivation of liberty without due process of law. Id., 196-97. Thus, in Georgia, the right of privacy is embraced in the requirement of due process.

The right of privacy applies to one’s bodily condition, including a right to be free of governmental bodily intrusion for the purpose of saving the patient’s life. Zant v. Prevatte, 248 Ga. 832 (1982) (prisoner, by virtue of his right of privacy, could refuse to be fed or intrusively examined, even for the purpose of saving the patient’s life); State v. McAfee, 259 Ga. 579, 580 (1989) (quadriplegic could terminate his life-sustaining treatment).

The right of privacy applies as well to information in one’s medical records, as recognized in the state’s Open Records Law, particularly OCGA § 50-18-72(a,2),[2] which prohibits public disclosure of records that are “Medical or veterinary records and similar files, the disclosure of which would be an invasion of personal privacy.” This provision forbids disclosure of “any information which would invade the constitutional, statutory or common law rights of ... privacy.” Napper v. Georgia Television Co., 257 Ga. 156, 160 (1987). Privacy protected by the Open Records Act recapitulates the privacy protected by the common law tort of invasion of privacy. Athens Observer, Inc. v. Anderson, 245 Ga. 63, 65 (1980); Harris v. Cox Enterprises, Inc., 256 Ga. 299, 301 (1986).

Physicians and hospitals are therefore subject to liability for the unauthorized disclosure of personal medical information. Johnson v. Rodier, 242 Ga. App. 496 (1) (2000) (no professional negligence affidavit required for invasion of privacy claim based on physician’s conversation with patient’s employer regarding patient’s mental state); Sletto v. Hosp. Auth. of Houston County, 239 Ga. App. 203 (1999) (hospital liable for sending privileged psychiatric records along with non-privileged medical records to adversary in response to requests for production to a third party in a personal injury case); Bala v. Powers Ferry Psychological Assoc., 225 Ga. App. 843 (1997) (psychologist who counseled patient liable for disclosing confidential information about patient to lawyer representing patient’s ex-husband); Payne v. Sherrer, 217 Ga. App. 761 (1995) (recognizing the duty of a physician to keep information about the patient private, but finding this duty inapplicable when the physician is appointed by the patient’s employer to evaluate his medical condition); Mrozinski v. Pogue, 205 Ga. App. 731 (1992) (psychiatrist liable for unauthorized disclosure of conclusions about a child in custody of father to ex-wife’s lawyer); Jones v. Thornton, 172 Ga. App. 412 (1984) (recognizing a physician’s duty to protect the privacy of patients, though the duty would be waived by the patient’s filing suit for injuries).

The scope of a patient’s privacy is not limited to the patient’s communications. Even diagnostic conclusions are subject to the patient’s privacy rights because such conclusions may indirectly disclose facts which the physician or hospital may not directly disclose. Mrozinski v. Pogue, 205 Ga. App. 731 (2) (1992). Ga. Rules & Regs. 290-1-2-.01(4) recognizes that “laboratory findings and diagnoses, by their very nature are confidential and personal to the person on whom reports are made and their physicians.” In Morton v. Skrine, 242 Ga. 844, 847-48 (1979) (refusing access to an investigatory file on a doctor), this court recognized:

[W]hat the board is inquiring into (a physician's medical practice) is a subject involving his patients' right to confidentiality. ... The doctor's performance cannot be totally separated from the physical person of the patient, so an investigation must necessarily tread on some very private ground.

Hence, the entire investigatory file was to be kept confidential except for presentation to the State Board of Medical Examiners, and then only under conditions allowing the hearing to be kept private. Id., 848-49.

Consequently, a patient has privacy rights in his or her entire medical record, since any part of it may, directly or indirectly, refer to protected private medical conditions.

III.  THE PATIENT’S RIGHT TO PRIVACY IN PERSONAL MEDICAL INFORMATION IS SUBORDINATE TO THE RIGHT OF AN ADVERSARY IN LITIGATION TO OBTAIN RELEVANT INFORMATION.

All cases recognizing a right of privacy have conceded that the right is not absolute. The right to privacy has always been balanced, by the judiciary, against the rights of other members of society to know and to speak. Where the individual takes some action that gives other members of society an interest in knowing the private fact, the courts have recognized an implied, but limited, waiver of the individual’s right to privacy.

The right of privacy is limited by the rights of others to know otherwise private information.

“The liberty of privacy exists, ... [b]ut it must be kept within its proper limits, and in its exercise must be made to accord with the rights of those who have other liberties, as well as the rights of any person who may be properly interested in the matters which are claimed to be of purely private concern. Publicity in many cases is absolutely essential to the welfare of the public.”

Pavesich, supra, 122 Ga. at 201.

“The right of privacy is not absolute, but is qualified by the rights of others. ‘No individual can live in an ivory tower and at the same time participate in society and expect complete non-interference from other members of the public.’”

Gouldman-Taber Pontiac, Inc. v. Zerbst, 213 Ga. 682, 684 (1957) (creditor of employee could notify employer of debt and seek assistance in having it paid).

As a result, “where an incident is a matter of public interest, or the subject matter of a public investigation, a publication in connection therewith can be a violation of no one’s legal right of privacy.” Waters v. Fleetwood, 212 Ga. 161, 167 (1956) (photographs of murder victim publishable). Hence, the bodily condition of a citizen, though generally protected by a right of privacy, may be subject to disclosure if it is the legitimate subject matter of a public investigation.

The right of privacy may also be waived, expressly or impliedly, but in either case a waiver is not necessarily total.

The existence of the waiver carries with it the right to an invasion of privacy only to such an extent as may be legitimately necessary and proper in dealing with the matter which has brought about the waiver. [Privacy] may be waived for one purpose and still asserted for another; it may be waived in behalf of one class and retained as against another class; it may be waived as to one individual and retained as against all other persons.

Pavesich, supra, 122 Ga. at 199. In the context of the Open Records Law, this Court has observed that a party may waive a privacy right, and that the waiver may be made expressly or by implication, and that the waiver may be in whole or in part. Doe v. Sears, 245 Ga. 83, 86-87 (1980). Therefore, where there is a waiver, there is a right to invade the person’s privacy “only to such an extent as may be legitimately necessary and proper in dealing with the matter which has brought about the waiver.” Id.

Hence, a waiver of privacy by a patient’s discussing his AIDS infection on television did not waive the agreed qualification that his face would be obscured, nor was this privacy right waived by his appearing on national broadcasts under similar conditions, nor by his telling friends, medical personnel, and a support group of his disease. Multimedia WMAZ, Inc. v. Kubach, 212 Ga. App. 707, 709-10 (1994) (“[W]aiver in this context is a relative term: the scope of the waiver is related to and limited by the scope of the actions on which the waiver is based”).

The filing of a lawsuit for personal injuries amounts to an implied waiver of the plaintiff’s privacy to the extent that the defendant may conduct a reasonable investigation regarding the validity of the plaintiff's claim, but “only in a reasonable and proper manner and only in furtherance of its interest with regard to the suit against it,” and the reasonableness of the investigation is a jury question. Ellenberg v. Pinkerton’s, Inc., 125 Ga. App. 648, 651-52 (1972).

Thus, the courts have recognized that the right to privacy is limited by the legitimate interests of others, and where a patient’s medical condition is legitimately in issue in a case, the courts will imply a waiver of the right to privacy as to that condition. Nevertheless, the waiver is limited, and restrictions remain on the use of the information, the persons to whom it may be disclosed, and the “reasonable and proper manner” in which it may be gathered.

IV.  THE RIGHT OF AN ADVERSARY TO OBTAIN A PATIENT’S PERSONAL MEDICAL INFORMATION IS LIMITED BY PROCEDURAL DUE PROCESS PROTECTIONS DESIGNED TO ENSURE THE RELEVANCE OF THE DISCLOSURE.

Procedural due process protections necessarily apply to the disclosure of private personal medical information for two reasons. First, the right of privacy arises from the concept of “liberty” within 1983 Ga. Const. Art. I, Sec. I, Par. I, which provides that “No person shall be deprived of life, liberty, or property except by due process of law.” Second, procedural due process pervades our entire system of justice, so that any compulsory disclosure of information must be accompanied by the protections of procedural due process. The judiciary strikes the balance between competing interests in the disclosure of privateinformation. Hence, such notice as will allow a patient to seek judicial intervention before a disclosure is made is required.

As noted above, the Pavesich court found that the right of privacy was guaranteed by the constitutions of the United States and Georgia in the prohibition of deprivation of liberty without due process of law. 122 Ga. at 196-97. Consequently, taken very literally, a patient may not be deprived of the liberty of privacy “except by due process of law.” 1983 Ga. Const. Art. I, Sec. I, Par. I. Thus, where the substantive right of privacy yields to the right of adversaries to know the facts, due process is still required. “[T]he principles of [procedural] due process ‘extend to every proceeding ... judicial or administrative or executive in its nature’ at which a party may be deprived of life, liberty, or property.” Cobb County School District v. Barker, 271 Ga. 35, 37 (2) (1999).[3]

Hence, even if an investigating agency may ultimately be entitled to obtain confidential records, a custodian may not simply turn them over to the agency without violating a patient’s or client’s rights to privacy. For example, a disclosure made voluntarily, without requiring the investigating agency to comply with procedures designed to ensure due process, subjects a professional to liability. Roberts v. Chaple, 187 Ga. App. 123 (1988) (accountant who disclosed client’s confidential information to special agent for the IRS without waiting for an administrative summons or judicial process was subject to liability for invasion of privacy). See also Jones v. Thornton, 172 Ga. App. 412 (1984) (treating physician, who responded to a request for production of documents filed by the patient’s adversary in tort litigation by mailing a copy of medical records on the date of receipt of the request, without waiting for the ten-day period in which the patient was authorized to object, “was lucky” that all records related to health matters in issue in the tort case, and thus was not liable for a breach of confidentiality).

The judiciary must strike the balance between the public interest in disclosure of public records and the public interest in recognizing personal privacy. Athens Observer, Inc. v. Anderson, 245 Ga. 63, 66 (1980). Where the state or a party is conducting an investigation into records that may include private protected information, a procedure including in camera review is necessary for protection of those parts of the records that remain legitimately private. Harris v. Cox Enterprises, Inc., 256 Ga. 299, 301 (1986) (adopting procedure for determining how much of a GBI report on the Georgia State Patrol should be released to the public). The trial court must weigh various factors to decide whether portions of records should be excluded from disclosure. Id., 302 (1). It must be the trial court, rather than the custodian of the records, that decides the question of what must be withheld from disclosure in order to protect legitimate privacy concerns. Id., 302 (2).

In order for the judiciary to strike the balance between competing interests and to set the scope of the waiver of privacy, notice must be given to the patient (or patient’s counsel in a pending case) so that he or she may invoke judicial oversight. The patient will know whether there is, or may be, private medical information that is not relevant to the issues in a pending case, whereas the prosecutor and medical records custodian (clerk) will very likely not know or care; the custodian will probably not know what the issues are in a pending case. The patient must be given notice so that he or she can seek judicial orders limiting the scope of the disclosure, or at least an in camera review of the records to be disclosed.

Simply sending a subpoena for records, without notice to the opposing party and an opportunity to be heard first on the validity or scope of the documents to be produced, violates procedural due process. For instance, the State Disciplinary Board issued an advisory opinion in which it found the issuance of a subpoena for the production of documents at a time and place other than a trial or deposition to be a violation of Standard 4. Advisory Op. No. 40. The primary problem with the procedure is lack of notice:

Non-party witnesses would be misled by such court process into releasing confidential or privileged material without the party having a chance to contest the relevancy, confidentiality or privilege of the material contained in the file because the subpoena is sent without notice to any other party or their counsel. Notice is a concept embraced by the Civil Practice Act. There is no need for notice of a subpoena issue[d] pursuant to OCGA § 24-10-22(a) because all parties receive notice of hearings and trials, so long as they are real hearings and real trials.

The Board found such subpoenas to be a fraud upon the court, the clerk, the person to whom the subpoena is directed, and the opposing party and counsel.

From the foregoing, it is apparent that the implied waiver of privacy in medical information that occurs when an adversary has a right to know about a patient’s medical condition does not include a waiver of procedural due process rights protecting a patient’s rights to have the scope and limits of the substantive waiver determined. There is, however, one Georgia case that appears to stand for a waiver of procedural due process rights. In Orr v. Sievert, 162 Ga. App. 679 (1982), the Court of Appeals recognized that a doctor has a professional and contractual duty to protect the privacy of patients, a breach of which gives rise to damages, but found that this duty is completely waived by placing the patient’s injuries in issue in a civil proceeding. Unfortunately, without analyzing the scope and limits of the waiver, the court stated that once a suit for such injuries is filed, “there no longer remains any restraint upon a doctor in the release of medical information concerning the patient within the parameters of the complaint,” id, at 679-80 (emphasis added). This amicus respectfully submits that Orr should be disapproved to the extent that it suggests that a patient who impliedly waives a right to keep his or her entire medical condition private also waives the constitutional right to procedural due process regarding any medical disclosures. Orr should be disapproved because:

1. Orr suggests, contrary to Pavesich and its progeny, that a waiver of the right to privacy is unlimited.

2. Orr suggests, contrary to Athens Observer and Cox, that the records custodian is well situated to determine what is and is not relevant to the issues in the case.

3. Orr is contrary to OCGA § 9-11-34(c)(2), which sets forth the procedure by which medical records may be obtained. Orr is incorrect in asserting that there is no restraint on a doctor’s releasing medical information on patients involved in litigation.

4. Notice to the patient will reduce the potential for abuse and overreaching that is inherent in ex parte investigation of the patient’s medical condition. The scope of the implied waiver of privacy may be in dispute. Unless the court can intervene, the scope of the patient’s privacy rights will be decided by (a) the patient’s adversary who is trained in the law and who knows what is in issue in a particular case, and (b) a medical records custodian or physician who are not trained in the law and who may rely entirely upon the patient’s adversary to understand the issues in the case.

5. Even if neither the adversary nor the custodian want to invade the patient’s privacy rights, both are placed in an untenable position because the adversary does not know in advance what information to seek and what to avoid, and the medical custodian cannot know the legal effect of disclosures upon the patient’s rights. Notice to the patient, leading either to consent or a court order, is the best way to resolve doubts.

6. Notice to the patient will reduce the possibility that a physician or hospital will (unknowingly) commit a breach of professional ethics[4] or a tortious invasion of privacy.

7. The physician-patient relationship is a confidential one, requiring the physician to exercise the utmost good faith to keep the patient’s confidences and to act in the best interest of the patient (though the physician is not an advocate for the patient and can be required to disclose the truth about the patient’s condition to the extent that the condition is legitimately in issue, whether the truth is beneficial or harmful to the patient’s case). There is in the relationship an atmosphere of trust, loyalty, and faith in the discretion of the physician. Ex parte disclosure of facts may be destructive of the relationship thus founded on the physician’s confidential and fiduciary roles.

8. Not all of the damage that can be done by overreaching ex parte investigation can be undone by applying motions to suppress, motions in limine, or other sanctions. For instance, the trust reposed in the physician-patient relationship may be irreparably injured by ex parte disclosures. Once an embarrassing public disclosure of irrelevant private medical information has occurred, it is too late to avoid the damage.

9. An adversary can get every bit of information about a patient’s medical condition that is legitimately in issue in a case without resorting to ex parte methods of investigation.

V.  THE PROCEDURE FOR OBTAINING MEDICAL RECORDS IN CIVIL CASES UNDER OCGA § 9-11-34(c)(2) PROVIDES ADEQUATE NOTICE AND OPPORTUNITY TO OBJECT TO SATISFY THE REQUIREMENTS OF PROCEDURAL DUE PROCESS AND TO RENDER CONFORMING SUBPOENAS “APPROPRIATE.”

The procedure enacted by the General Assembly in civil cases for the production of documents gives adequate notice and an opportunity to be heard to a civil litigant. OCGA § 9-11-34(c)(2) requires a party seeking a patient’s medical records to give notice to the patient of the request for production to a medical care provider, and gives the patient ten days in which to file an objection to the disclosure, which may not proceed until further order of the court. If an objection is filed, the court may make an in camera review of the proposed disclosure to determine whether there is a legitimate privacy interest in the records and may issue any protective order under OCGA § 9-11-26(c) that protects such interests while allowing legitimate discovery tocontinue. The implementation of a similar procedure in criminal cases would satisfy any procedural due process concerns. A criminal defendant clearly should be entitled to the same notice and opportunity to object that is provided to a civil litigant. Presumably, a criminal defendant would have at least as compelling of a need to review a subpoena for appropriateness.

Because of the heightened privacy interest that the State of Georgia recognizes in a patient’s “medical information,” OCGA § 24-10-22 and OCGA § 24-9-40 should be construed to require at least the following procedure in any case where an “appropriate” trial subpoena seeks “medical information”: (a) Service of a copy of the subpoena on the person or person about whom “medical information” is sought; (b) Service of the subpoena sufficiently in advance of trial or the giving of testimony – at least 10 days -- so that a motion to quash the subpoena (or other proper objection) can be filed in advance of the production of any medical information.

This amicus submits that a unified standard for an “appropriate” subpoena of “medical information” should apply in Georgia. This standard should be the same whether the information is sought at trial – whether criminal or civil -- or during pre-trial discovery. If accepted, the GTLA argument would align the procedure for the subpoena of “medical information” at trial with the procedure for the production of such information from non-parties during civil discovery. See OCGA § 9-11-34(c). With respect to the disclosure of “medical information,” a criminal defendant should have the same protections as a civil litigant.

CONCLUSION

For the foregoing reasons, this amicus respectfully submits that the intention of the legislature would be furthered by requiring that subpoenas for medical records under OCGA § 24-9-40 have the same procedural requirements of notice and opportunity to object which are embodied in Rule 34 of the Civil Practice Act, both as a matter of statutory construction and to vindicate a patient’s procedural due process rights to protect legitimate privacy interests from unwarranted ex parte disclosure.

Respectfully submitted, this July 14, 2000.

/s/
CHARLES M. CORK, III
Reynolds & McArthur
P. O. Box 6897
Macon, Georgia 31208-6897
(912) 741-6000
/s/
Albert M. Pearson, III
Moraitakis, Kushel & Pearson
Suite 425
3445 Peachtree Road
Atlanta, Georgia 30326
(404) 261-0016

[1] In the part pertinent here, the statute provides: “No physician ... and no hospital ... shall be required to release any medical information concerning a patient except ... on appropriate court order or subpoena ... .” (Emphasis added.)

[2] Recognition of a right of privacy in medical records also occurs in the Freedom of Information Act. 5 U.S.C. § 552 (a)(3).

[3] There is a suggestion that due process does not apply to subpoenas issued prior to the filing of formal charges (Wills v. Composite State Bd. of Medical Examiners, 259 Ga. 549, 551, citing Gilmore v. Composite State Bd. of Medical Examiners, 243 Ga. 415 (1979)), but as explained above by Morton v. Skrine, 242 Ga. 844, 847-48 (1979), the context was an administrative hearing in which the privacy of patients would be protected.

[4] The Hippocratic Oath states, in part, “Whatever, in connection with my professional practice or not in connection with it, I see or hear, in the life of men, which ought not to be spoken abroad, I will not divulge, as reckoning that all such should be kept secret.” (“Abroad” in this phrase bears the older meaning of “outside” or “in public.”)

Principle IV of the AMA’s Principles of Medical Ethics requires physicians to “safeguard patient confidences within the constraints of the law.”

Section 5.05 of the Current Opinions of the Judicial Council of the AMA states that “The information disclosed to a physician during the course of the relationship between physician and patient is confidential to the greatest possible degree.”

OCGA § 43-34-37(a)(7,11) prohibits unprofessional conduct and acts indicating untrustworthiness.