Horne v. Patton, 287 So. 2d 824 (Ala. 1973) (Supreme Court of Alabama)
Horne v. Patton is a leading Alabama Supreme Court decision that squarely recognizes a health-care provider's common-law duty to maintain the confidentiality of a patient's medical information.
Does Alabama recognize a civil cause of action against a physician (or dentist) for making an unauthorized extra-judicial disclosure of confidential medical information obtained in the course of treatment, and, if so, what are the contours and exceptions of that duty?
A physician (including dentists and other health-care providers in a physician-like role) owes a common-law duty to maintain the confidentiality of medical information acquired in the course of the professional relationship. Unauthorized, extra-judicial disclosure of such information can give rise to liability sounding in tort (e.g., invasion of privacy/breach of fiduciary duty) and/or in contract (breach of an implied promise of confidentiality). This duty is distinct from, and not limited by, the absence of an evidentiary physician-patient privilege. Recognized exceptions permit disclosure when: (1) required or authorized by law (e.g., public health reporting, court order, subpoena with appropriate safeguards); (2) necessary to protect or advance the patient's care (including consultation among health-care personnel involved in treatment); (3) justified by a superior public interest (e.g., preventing serious harm to identifiable third parties or controlling communicable diseases); (4) consented to by the patient (expressly or impliedly); or (5) reasonably necessary to defend the physician in litigation initiated by the patient regarding the care. Damages may include mental anguish and, upon proper showing, punitive damages for willful or malicious breaches.
Yes. The Alabama Supreme Court recognized a common-law duty of medical confidentiality and held that the plaintiff's complaint stated cognizable tort and contract claims for unauthorized disclosure. The court reversed the dismissal and remanded, noting that whether any exception or privilege justified the disclosure is a factual question not resolvable on the pleadings.
Horne v. Patton is a foundational Alabama case on medical confidentiality. It establishes that: (1) the physician-patient relationship creates a substantive duty of confidentiality enforceable in tort and contract; (2) that duty is independent of evidentiary privileges; (3) mental-anguish damages are recoverable for wrongful disclosures; and (4) limited, policy-driven exceptions exist but are narrowly construed and fact-dependent. For law students, the case illustrates how courts craft common-law duties from professional norms, reconcile them with competing public interests, and translate those duties into actionable claims under privacy and implied-contract theories.