Confidentiality

Question 1

Confidentiality is always maintained unless? (3)

Answer 1

1. Consent given by patient
2. Required by law
3. It is in the wider public interest

Question 2

What types of consent can be given by the patient to breach confidentiality?

Answer 2

• Implied consent e.g. by presence of the MDT, patients in hospital give implied consent for the doctor to share their info with the rest of the MDT
• Express consent - used when patient info needs to be shared with others not involved in the patient’s care

Question 3

In general, when should we obtain express consent? (3)

Answer 3

When in doubt about:
- The nature of info e.g. attendance at a clinic
- The form of disclosure e.g. letter to GP, hospital notes, electronic record
- To whom e.g. relative/carer

Question 4

When is it in the wider public interest for confidentiality to be breached?

Answer 4

• Dangerous driver
• Infectious diseases
• Prevention of serious crime (like murder and that)

Question 5

When required to breach confidentiality, what rules should we follow? (2)

Answer 5

• give the minimum amount of information necessary
• Good to inform patient when you have to breach confidentiality (unless it defies objective of breaching confidentiality)

Question 6

What is the ruling with patient’s relative and confidentiality?

Answer 6

Relatives do not have a right to know about the patient unless:
- they are the parent of a child who is not Gillick competent
- the patient doesn’t have capacity so next of kin can have a right to be consulted under the Mental Capacity Act

Question 7

Disclosures required by statute do not require consent- which include? (4)

Answer 7

• notification of death
• notification of termination
• treatment of drug addicts with specific drugs
• notifiable infectious diseases

Question 8

Conditions in which to disclose information to police? (3)

Answer 8

• under warrant from circuit judge
• to aid police request to identify drivers suspected of road traffic offences
• to aid police in all matters regarding terrorism

Question 9

What info can you give them (police) and what can you not?

Answer 9

Only identification details like address, but not medical results (like blood alcohol levels)

Question 10

With children, how does confidentiality work? (3)

Answer 10

• If <16 and not gillick competence confidentiality can be breached if it is thought to be in the best interests of the child
• If child is gillick competent or >16 they can refuse consent to disclosure, but this can still be lawfully breached if it is in the child’s best interest up until age of 18
• However it is generally not in the child’s best interests (if they’re competent) to override their refusal of disclosure

Question 11

What must med students do in terms of confidentiality with children?

Answer 11

• Don’t enter an agreement with a child where you have to keep what they’ve told you a secret
• At the same time if they tell you something and tell you not to tell anyone, you don’t want to ruin the trust of the child with you and future interactions with the MDT

Question 12

When does confidentiality continue until?

Answer 12

No end limit → confidentiality must continue beyond death