Confidentiality Flashcards
Privacy
The condition of not having personal information about oneself known by other people = patient’s right
Confidentiality
The ethical principle that requires nondisclosure of private or secret information with which one is entrusted = health care professional’s
Respect
obligation to treat all patients with dignity
Quebec Civil Code 35
Every person has a right to the respect of his reputation and privacy. No one may invade the privacy of a person without the consent of the person unless authorized by law.
Quebec Civil Code: 37
Every person who establishes a file on another person shall have a serious and legitimate reason for doing so. He may gather only information which is relevant to the stated objective of the file, and may not, without the consent of the person concerned or authorization by law, communicate such information to third persons or use it for purposes that are inconsistent with the purposes for which the file was established. In addition, he may not, when establishing or using the file, otherwise invade the privacy or damage the reputation of the person concerned.
Quebec Charter of Human Rights and Freedoms: Fundamental freedoms and rights
- Every human being has a right to life, and to personal security, inviolability and freedom. He also possesses juridical personality.
- Every person has a right to respect for his private life.
- Every person has a right to non-disclosure of confidential information. No person bound to professional secrecy by law and no priest or other minister of religion may, even in judicial proceedings, disclose confidential information revealed to him by reason of his position or profession, unless he is authorized to do so by the person who confided such information to him or by an express provision of law. The Tribunal must, ex officio, ensure that professional secrecy is respected.
CNA code of ethics
- Maintaining privacy and confidentiality is a core nursing value and ethical responsibility.
- “Nurses recognize the importance of privacy and confidentiality and safeguard personal, family and community information obtained in the context of a professional relationship.”
Confidentiality
Means respecting the client’s right to keep private any information about his or her mental and physical health and related care
Disclosure
Nurses must disclose a person’s health information only as authorized by that person, unless there is substantial risk of serious harm to the person or to other persons or a legal obligation to disclose
STATUTORY DUTY OF DISCLOSURE
- Certain communicable diseases: i.e. HIV/AIDS, tuberculosis (in Quebec we have MADO - Maladies à déclaration obligatoire), rabies, H1N1, SARS, e-coli
- One must report the identity of the patient and nature of the disease
- The virulence and seriousness of these illnesses justify the infringement on the patient’s right to privacy
- If the patient is threatening bodily harm to others or to himself/herself
- Spouse/child abuse
- Workers’ Compensation (CSST in Quebec)
- Court order (health record for court proceedings)
- Negligence or incompetent practices on the part of health care professionals
- Genetics
- Patient’s family
- **Nurses should be able to reasonably foresee harm or injury to an innocent other in order to justify violating the principle of confidentiality in favor of the duty to warn (non-maleficent) **
Ethical vs Legal rights and Obligations
- A Right - claim or privilege to which one is justly entitled, either legally or morally
- Each right carries a corresponding obligation
- Legal rights and moral rights
- Moral and legal rights carry the obligation to ensure a patient’s right and that all applicable standards of practice are observed
THE TREATMENT SETTING (Concrete examples that exposes privacy)
- Casual conversations any where in the hospital, ward
- Elevator-talks
- “Walls have ears”
- Hallways: can produce “echo” and transfer the sound to other people in the hallway
- Discussion with a colleague
- ER d/t shared beds in the same room
- OPD
Interventions
- Draw curtains
- Talk softly
Ethical Dilemma: HIV
- Private matter
- Well-founded fears about confidentiality
- Stigma and discrimination (if other people know; the pt will be at a disadvantage and vulnerable since people fear of contracting it via touch)
- Denial of access can be detrimental to good patient care
Computer Records Pro
- Computerized system
- Wider access, increased data, greater number of people
- Improve communication
- Documentation improved
- Pharmacological control improved
ELECTRONIC DOCUMENTATION
Safeguarding for electronic health records entails the following guidelines
- Never reveal your password or your ID number
- Inform your manager if you suspect unlawful use
- Change passwords
- Choose undecipherable password
- Log off when not using the terminal
- Maintain confidentially of all information, including hard copy
- Shred and discard print information containing confidential information
- Locate printers in secured areas away from public access; pick up doc asap
- Retrieve printed information immediately
- Protect patient information displayed on monitors (use of screen saver and/or privacy screens, location of monitor)
- Only access information required in providing care to a particular patient (accessing patient information for purposes other than providing care is considered a breech of confidentiality)
