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MED 105- MEDICAL ETHICS > 14. BREACHING CONFIDENTIALITY > Flashcards

14. BREACHING CONFIDENTIALITY Flashcards

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USMLE® Step 1 flashcards
1
Q
  1. Can the hospital doctor share this information with the long-term care facility?
A

ONCE PATIENTS ARE ADMITTED TO THE MEDICAL SETTING:
- they sign a consent form
- this allows all of their information be shared amongst
the clinical team
- the doctor can share this information with the long
term care facility
- unless the patient explicitly outlines that they would
not like this information to be shared

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2
Q
  1. What are the 4 justifications for breaking Confidentiality?
A
  1. WITH THE PATIENT’S CONSENT
  2. IN THE PATIENT’S BEST INTERESTS
    - if the patient is incompetent
    - children
  3. WITH REGARDS TO PUBLIC INTEREST
    - public safety
    - public health
    - this is when the public interest in breaking
    confidentiality outweighs the public interest in
    maintaining confidentiality
  4. DISCLOSURE OF INFORMATION
    • that is required by the laws, courts and approved
      through the statutory process
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3
Q
  1. List 7 Statutory Requirements of the UK?
A
  1. Notifications of birth
  2. Still Births
  3. Deaths
  4. Termination of Pregnancy
  5. Fertility Treatment
  6. Notifiable and Communicable Diseases
  7. Poisonings and Serious Work Accidents
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4
Q
  1. List another 7 Statutory Requirements of the UK?
A
  1. Criminal Investigations
  2. Terrorism
  3. Child Abuse
  4. Court Orders
  5. DVLA
  6. Drug Addiction
  7. Traffic Accidents
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5
Q
  1. List 7 Particular Problems of Confidentiality?
A
  1. The Impaired Driver
  2. Abused Patient
  3. Patient with gunshot or knife wounds
  4. The drug dependent patient
  5. Request to report to the police
  6. Sexually Active Minor
  7. Communicable Diseases
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6
Q
  1. What is meant by the “Impaired Driver”?
A
  • The Driver Vehicle and Driving Agency (DVLA)
    establishes the fitness to drive
  • doctors have a professional obligation to ensure that
    the DVLA is aware of anyone who is medically unfit
    and unsafe to drive
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7
Q
  1. What is meant by the “Abused Patient”?
A
  • these patients have limits to their intervention
  • they are not considered fully capacious patients

IN THE CASE OF A CHILD:
- there is special guidance to report under Child
Protection and Safeguarding

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8
Q
  1. What is meant by the “Patient with gunshot or knife wounds”?
A
  • doctors have to inform the police in these situations
  • the doctors have to consider whether a patient poses a
    risk of serious harm to others
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9
Q
  1. What is meant by the “The Drug Dependent Patient”?
A
  • the Duty of Confidentiality to drug-abusing patients is
    the same as with any other patient
  • the prescription of controlled drugs needs to be
    recorded in the drug misuse database
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10
Q
  1. What is meant by the “Request to report to the police”?
A

IN GENERAL:
- there is no obligation to report to the police
- the police do not have automatic powers to demand
disclosure

THERE ARE EXCEPTIONS:
- this looks at personal identifiers vs clinical records
- it is a good doctor’s practice to ask for written
requests
EG: traffic accidents, serious crimes, terrorist acts

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11
Q
  1. What are the 3 ways in which you can breach confidentiality against a child’s wishes?
A
  1. Overriding Public Interest
  2. Best Interest of the Incompetent Child
  3. Disclosure that is required by the Law
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12
Q
  1. What can be said about the duties of Confidentiality with regards to children and young people?
A
  • the same duties of confidentiality apply when using,
    sharing or disclosing information about children and
    young people as with adults
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13
Q
  1. What is meant by “Sexually Active Minor”?
A
  • this is a case of abuse vs consent
  • there is a fear about confidentiality and this deters
    some teenagers from seeking early sexual health
    advice
  • young people need to trust the confidentiality of
    general medical practice
  • this will allow them to seek advice on other personal
    issues
  • EG: drugs, bullying, depression
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14
Q
  1. What is meant by “Communicable Disease”?
A
  • a doctor must notify the relevant local authority
    officers if they suspect that a patient has a notifiable
    disease
    (TB or Covid-19)
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15
Q
  1. Give 2 examples of diseases that are not notifiable?
A
  • HIV
  • AIDS
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16
Q
  1. When is it necessary to disclose information regarding a notifiable disease?
A
  • this information should be disclosed when it benefits
    public interest
  • there must be a real and serious risk of physical harm
    to an identifiable individual
  • disclosure of the information must be made only to
    those who are in vital need of the information
17
Q
  1. Read through this case.
    Does everything make sense?
A

NB:
- operations on under 16 year old should have parental
consent

18
Q
  1. Is confidentiality absolute?
A
  • no
  • it is however legally and ethically important
19
Q
  1. According to the GMC Confidentiality Guidance, in which situations can a doctor disclose personal information without breaching the duties of confidentiality?
A
  1. THE PATIENT CONSENTS
    - this can be implicit or explicit
  2. THE DISCLOSURE PROVIDES AN OVERALL BENEFIT TO
    THE PATIENT
    • this patient lacks the capacity to consent
  3. THE DISCLOSURE IS REQUIRED BY THE LAW
    • it can be approved under a statutory process
    • this process will set aside the common law duty of
      confidentiality
  4. THE DISCLOSURE CAN BE JUSTIFIED IN THE PUBLIC
    INTEREST
20
Q
  1. According to the GMC Confidentiality Guidance, what steps are followed when we disclose patient information?
A
  1. Use anonymised information
  2. Ensure the patient is satisfied
  3. Get the patient’s explicit consent when disclosing
    identifiable information
  4. Keep disclosures to the minimum necessary for the
    purpose
  5. Follow all relevant legal requirements
21
Q
  1. When do we “use anonymised information”?
A
  • only use this information if it is practicable to do so
  • use this information if it will serve the necessary
    purpose
22
Q
  1. What does it mean to: “ensure that the patient is satisfied”?
A
  • the patient is informed about how their information
    will be used
  • the patient has the right to object
  • the patient has not objected to their information being
    used
23
Q
  1. In which situations do we “get the patient’s explicit consent if identifiable information is to be disclosed”?
A
  • in situations relating to the patient’s direct care
  • or their local clinical care
  • this information disclosure can also be required by the
    law or serve public interest
24
Q
  1. What is an example of a “relevant legal requirement” that is to be followed?
A
  • data protection laws
25
Q
  1. Read through this summary.
    Does everything make sense?
A
  • yes
26
Q
  1. Answer these questions.
A
  • you can do this verbally or on paper

MED 105- MEDICAL ETHICS (36 decks)

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