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Mandatory reporting: public health, violence and abuse

  • Topic

The law requires doctors to report certain diseases to Sivigila and to alert the authorities to sexual abuse and child maltreatment.

Updated

What it is

Mandatory reporting is one of the exceptions to professional secrecy. In public health, providers must report events of public health interest to the Public Health Surveillance System (Sivigila), created by Decree 3518 of 2006 and now compiled in Decree 780 of 2016. For violence, Law 1146 of 2007 and Resolution 459 of 2012 require sexual violence to be treated as an emergency and reported to the authorities, and Law 1098 of 2006 requires the health system to detect and report child maltreatment.

Key facts

  • Decree 780 of 2016, art. 2.8.8.1.1.13: providers are primary data-generating units and must report events under surveillance within the set deadlines.
  • Decree 780, art. 2.8.8.1.2.4: professional secrecy is no obstacle to giving the health authority information on an event of public health interest.
  • Decree 780, art. 2.8.8.1.2.5: people's identity in surveillance is confidential and is used only by health authorities, or by judicial ones with a court order.
  • Law 1146 of 2007, art. 9: sexual abuse of a minor is treated as an emergency, whatever their insurance status, with immediate notice to the judicial police and the ICBF (child welfare institute).
  • Law 1146, art. 15: the State and society must report any sign of sexual abuse of minors within 24 hours of learning of it.
  • Resolution 459 of 2012: adopts the Protocol and Model of Comprehensive Health Care for Victims of Sexual Violence, mandatory for insurers (EPS) and providers (IPS).
  • Law 1098 of 2006, art. 46, no. 10: the health system must train its staff to detect maltreatment and abuse of minors and report them to the authorities.

Step by step

  1. Treat first: the medical emergency and the patient's safety come before paperwork.
  2. Recognise the event: notifiable disease, sexual violence, child maltreatment or other violence.
  3. Record in the medical record the findings, the injuries and what the patient reports, in their own words.
  4. In sexual violence, apply the protocol of Resolution 459 of 2012 and preserve evidence under chain of custody.
  5. Report the public health event to Sivigila through the institution, within the protocol's deadline.
  6. In abuse or maltreatment of minors, alert the judicial police and the ICBF (Law 1146, art. 9), within 24 hours.
  7. Tell the patient or their representative what is reported and why, unless that would increase the risk.

In clinical practice

  • Reporting to Sivigila does not breach professional secrecy: Law 23 (art. 38, letter d) allows disclosure to health authorities in cases set by law.
  • Lack of insurance is no excuse for not treating a minor who is a victim of sexual abuse (Law 1146, art. 9).
  • Law 1146 (art. 9, no. 1) requires sexual abuse of minors to be classified and treated as a medical emergency.
  • Decree 3518 of 2006 (Sivigila), compiled in Decree 780 of 2016, Book 2, Part 8, Title 8, Chapter 1 (arts. 2.8.8.1.1.1 onwards).
  • Law 1146 of 2007, arts. 9, 10 and 15; partly amended by Law 2137 of 2021. Resolution 459 of 2012 of the Ministry of Health.
  • Law 1098 of 2006 (Code of Childhood and Adolescence), arts. 18 (defines child maltreatment) and 46 (duties of the health system).
  • Law 23 of 1981, art. 38, letter d: secrecy may be disclosed to judicial or health authorities in the cases set by law.

Test yourself

Think of the answer, then tap the question to see it.

May a doctor refuse to give information to Sivigila citing professional secrecy?

No. Decree 780 of 2016 (art. 2.8.8.1.2.4, formerly Decree 3518 of 2006) says professional secrecy is no obstacle to giving that information to the health authority.

Who is alerted when a minor who is a victim of sexual abuse is treated?

The judicial police and the ICBF, immediately (Law 1146 of 2007, art. 9); the report must be made within 24 hours (art. 15).

Which rule adopts the health care protocol for victims of sexual violence?

Resolution 459 of 2012 of the Ministry of Health, mandatory for insurers (EPS) and providers (IPS).

Which law requires the health system to detect and report child maltreatment?

Law 1098 of 2006 (Code of Childhood and Adolescence), art. 46, number 10.

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Connections

← All of medical ethics

Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal.

Sources: Decreto 780 de 2016, Book 2, Part 8, Title 8: Public Health Surveillance System (compiles Decree 3518 of 2006) (Ministerio de Salud y Protección Social, 2016); Ley 1146 de 2007, prevention of sexual violence and comprehensive care of sexually abused children and adolescents (Función Pública, Gestor Normativo, 2007); Resolución 459 de 2012, Protocolo y Modelo de Atención Integral en Salud para Víctimas de Violencia Sexual (Ministerio de Salud y Protección Social, 2012); Ley 1098 de 2006, Código de la Infancia y la Adolescencia (Función Pública, Gestor Normativo, 2006).

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