by Gloria Orrego-Hoyos, María Lina Carrera
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS. Volume 174, Issue 3. pp. 1683-90
Ethical and Legal Issues in Reproductive Health: Free Access. First published: 1 July 2026.
Wiley Online Library. https://obgyn.onlinelibrary.wiley.com/doi/10.002/ijgo.71195
Abstract
This article examines systematic breaches of medical confidentiality in Argentina’s reproductive healthcare system, where healthcare providers often report patients experiencing obstetric emergencies to law enforcement agencies. Drawing on judicial records, interviews with healthcare professionals, and analysis of medical curricula, the study shows how structural weaknesses, regulatory ambiguities, and biases in medical education undermine professional confidentiality, turning hospitals into patients’ entry points to the criminal justice system rather than spaces of care. Despite strong constitutional protections and Supreme Court rulings affirming patients’ rights to confidentiality, significant gaps persist between legal standards and practice. Situating Argentina within broader Latin American patterns, the article argues that clearer institutional guidelines, improved professional training, and consistent judicial interpretation are needed to align medical practice with human rights standards and rebuild patient trust.
Introduction
In the context of reproductive health, breaches of medical confidentiality undermine not only trust in healthcare but can also transform hospitals into patients’ entry points to criminalization, which disproportionately affects women who have had abortions or miscarriages.
Medical confidentiality constitutes a foundational element of the doctor–patient relationship, ensuring dignity, trust, and the effective delivery of healthcare services. It is a fundamental principle recognized globally as essential to healthcare delivery and human dignity. The imperative to preserve confidentiality is crucial for creating a safe space where patients feel comfortable sharing health information, particularly in personally sensitive fields like sexual and reproductive health.
In Latin America, however, this principle is increasingly eroded in the context of reproductive health. Women experiencing miscarriages or obstetric emergencies are often subjected to criminal proceedings triggered by disclosures to law enforcement authorities made by healthcare providers, effectively transforming hospitals from spaces of care into patients’ entry points to the criminal justice system. Healthcare professionals find themselves caught between legal regulations compelling disclosure and their duty to provide confidential care. This tension places an enormous burden on medical personnel, who must navigate unclear guidelines while facing potential legal consequences for their decisions.
This article draws its primary qualitative and quantitative empirical evidence from the comprehensive study presented in our book Entra una paciente, sale una denuncia. Conducted over two years with the support of the O’Neill Institute at Georgetown University, the research employs a multi-methodological approach to map structural threats to medical confidentiality in Argentina. Its core features over 100 standardized interviews with health and legal professionals across nine provinces, supplemented by field observations in “opaque” settings such as hospital and private health clinics’ wards and courtrooms, ensuring a representative national panorama of the systemic biases that transform clinical spaces into patients’ entry points for the criminal justice system.
To complement this fieldwork, the study includes a rigorous analysis of 19 university curricula to assess how professional confidentiality is taught, alongside a historical review of landmark judicial rulings, such as Natividad Frías and Baldivieso. By synthesizing these qualitative testimonies with documentary and academic data, the methodology effectively exposes the “gearwork” behind the breach of confidentiality and the subsequent criminalization of patients. This robust empirical framework serves as the cornerstone for the conclusions and arguments developed throughout the present article.
The analysis situates Argentina within a broader regional context, where similar tensions arise. For example, in El Salvador, the absolute prohibition of abortion causes doctors to report suspected abortions to the authorities for fear of being prosecuted, turning obstetric emergencies into police interrogations, while in Peru the General Health Law requires medical personnel to report so-called “criminal abortions.” In Brazil, healthcare professionals can be also required to disclose information about suspected illegal abortions during criminal investigations or legal proceedings.
This article proceeds in four stages. First, it outlines the Argentine legal and ethical framework and examines international standards regarding medical confidentiality. Second, it analyzes how these normative regimes operate in practice, focusing on the criminalization of women in reproductive health care. Third, it identifies the structural factors—including gaps in medical education and institutional pressures—that condition breaches of professional secrecy. Finally, it proposes avenues for reform and the strengthening of confidentiality protections, incorporating judicial principles such as the “inhumane dilemma” and the exclusionary rule as essential tools to reclaim the hospital as a sanctuary of care.
Section Headings
- CONFIDENTIALITY: ARGENTINE AND INTERNATIONAL STANDARDS
- HOW THE STANDARDS OPERATE IN PRACTICE
- STRUCTURAL FACTORS CONDITIONING BREACHES OF CONFIDENTIALITY
- STRENGTHENING THE PROTECTION OF CONFIDENTIALITY
Conclusions: Reclaiming the Sanctuary of Care
This study underscores that protecting patient confidentiality within the Argentine healthcare system is both an ethical imperative and a rigorous legal requirement. Although Argentina possesses a robust normative framework, the persistent fear of legal repercussions continues to distort physician behavior, particularly in reproductive health. As exemplified by the Inter-American Court in Manuela v. El Salvador, the intersection of gendered assumptions and medical breaches can produce devastating results, transforming obstetric emergencies into criminal investigations. These risks are exacerbated by gaps in medical education, where an “underlying curriculum” often reinforces informal practices that neglect patients’ rights in favor of defensive medicine.
The findings point toward a necessary coordinated path forward. It is not enough to have strong laws; they must be supported by universal institutional guidelines and a culture of professional security. Clinical practice must be shielded by legal and professional authorities that explicitly support physicians who uphold their duty of confidentiality. By addressing these structural and educational dimensions, we can transition from a model of medical surveillance to one of patient-centred care.
In conclusion, safeguarding confidentiality depends on the synergy between robust jurisprudence, comprehensive education, and institutional support. Protecting those who provide care is a prerequisite for protecting those who receive it. Only by ensuring that physicians can act without fear of professional or legal sanction can we restore the physician–patient relationship as a space of trust. Ultimately, medical confidentiality functions as a core guarantee of human rights and as an essential condition for the integrity of the public health system.