Confidentiality

Question 0

What is the legal basis for confidentiality?

Answer 0

Human rights act 1998

Everyone has a right to respect his private life and family
There shall be no interference by public authority except in accordance with the law in a interest of national security, public safety , protection of health of others or to protect the right and freedom of others

Question 1

What are the two distinct ethical approaches to confidentiality.

Answer 1

1. The patient perspective- patient is concerned with maintaining confidentiality for protection of his autonomy.
2. Healthcare perspective- looks at professional autonomy. Professionals are experts in their own right and certain info should be theirs and theirs alone. They may loose there autonomy and clinical judgement may be in jeopardy.

Question 2

What is common law duty?

Answer 2

The common law duty of confidentiality may arise in three ways

1. Duty of care in negligence
2. For the implied duties under a healthcare professionals contract which requires employees to keep info confidential.
3. From an equitable duty which nestles situated keeping confidential info that has been passed on in confidence.

Question 3

What are there exceptions to confidentiality?

Answer 3

1. Patient consent - needs to be specific about which info the patient is happy for you to pass on.
2. Disclosure within a treating healthcare team- it is under assumption that patients are always aware that info will be shared within the team- must clarify this with the patient. Different levels of access depending on how much people need to know,
3. Disclosures about patients who lack capacity- those deemed incapacitated by the mental capacity act 2005. Make sure patients best interests are the primary concern. Encourage patient to be involved and divulge on a need to know basis.
4. Disclosure to other third parties- employers or insurance companies. Healthcare prof has a duty to the employer rather than the employee. In any case ask for permission from the patient.
5. Statutory disclosure- certain statues necessitate disclosure ( abortion act, miss use of drugs act) or if there is overriding public interest
6. Disclosure by court- criminal cases and litigation, may object if you think the info needed is irrelevant
7. In public interest - rests on subjective definitions of best interests. Healthcare professionals are under no obligation to disclose to the police but they cannot mis lead them. Prevention of terrorism is an exception to this rule

Question 4

What you must think if you are going too disclose info

Answer 4

Benefits of disclosing against harm with breaching confidentiality
Assess the urgency of the disclosure
Try to persuade the patient to disclose voluntarily
Inform the patient before making the disclosure and try to seek consent unless his increases the risk of harm or the investigation
Disclose promptly and tot the right body
Reveal only the minimum amount of info
Seek assurance the info will only be used for the purpose it was disclosed
Justify the decision
Document both the extent sand the grounds for the disclosure

Question 5

What are the principles in practise

Answer 5

Patients have the right to expect confidentially unless they give consent to disclosure.
If they consent to disclosure you must ensure they know what hey are consenting to
You must respect the patient decision not to disclose unless they are a risk to others
Disclosure should be minimal and justified.
Must ensure the individual recognises that the info you are providing is confidential