McCormick v. England
494 S.E.2d 431, 1997 S.C. App. LEXIS 158, 328 S.C. 627 (1997)
Rule of Law:
A physician has a legal duty to maintain the confidentiality of a patient's information, and an unauthorized extra-judicial disclosure gives rise to a cause of action in tort, unless the disclosure is compelled by law or is justified by a supervening interest, such as protecting the patient or others.
Facts:
- Dr. Kent England served as the family physician for Sally McCormick, her husband, and their children.
- McCormick and her husband became involved in a divorce action where custody of their children was a central issue.
- Dr. England prepared a letter addressed 'To, Whom It May Concern' regarding McCormick's health.
- In the letter, Dr. England diagnosed McCormick with 'major depression and alcoholism, acute and chronic.'
- The letter further stated his medical opinion that McCormick was 'a danger to herself and to her family' and required hospitalization.
- McCormick's husband submitted Dr. England's letter to the family court to support his motion in the divorce proceedings.
- There was no indication in the record that the letter was prepared under a court order or subpoena.
Procedural Posture:
- Sally McCormick filed a complaint against Dr. Kent England in a special circuit court (the trial court).
- The complaint included a fifth cause of action for breach of confidence.
- Dr. England filed a motion to strike the breach of confidence cause of action, arguing it failed to state a claim upon which relief could be granted.
- The trial court judge granted Dr. England's motion, finding that South Carolina did not recognize a physician-patient privilege or a cause of action for breach of confidentiality.
- McCormick filed a motion to alter or amend the order, which the judge denied.
- McCormick, as the appellant, appealed the trial court's order to the Court of Appeals of South Carolina.
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Issue:
Does South Carolina recognize a cause of action for a physician’s breach of the duty of confidentiality?
Opinions:
Majority - Anderson, J.
Yes. South Carolina recognizes a cause of action in tort for a physician’s breach of the duty of confidentiality. The court distinguished the evidentiary physician-patient privilege, which South Carolina does not recognize, from the professional duty of confidentiality. The former applies to in-court testimony, while the latter applies to extra-judicial disclosures. The court reasoned that public policy strongly supports confidentiality to encourage patients to make full disclosures to their physicians for effective treatment, a principle rooted in the Hippocratic Oath and modern medical ethics. This duty is also supported by state regulations empowering the medical board to discipline physicians for such breaches. The court held this new tort is distinct from invasion of privacy, as a breach of confidentiality does not require widespread publicity or that the information be 'highly offensive.' The duty is not absolute and may be overcome by a compelling public interest or legal mandate, such as the need to protect the patient or others from harm.
Analysis:
This case establishes a new common law tort in South Carolina, providing patients with a legal remedy for unauthorized disclosures of medical information by their physicians. The decision is significant for clearly separating the concept of testimonial privilege (which South Carolina lacks for physicians) from the broader ethical and legal duty of confidentiality in extra-judicial contexts. This ruling aligns South Carolina with the majority of U.S. jurisdictions and creates a framework for balancing patient privacy against public safety. Future cases will likely focus on defining the scope of the 'compelling public interest' exception, determining when a physician's disclosure is legally justified.
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