confidentiality Flashcards
What are three ethical approaches to keeping patient’s personal info confidential?
Consequentialist
Autonomy
Duty
Consequentialist approach to confidentiality
Whether or not an action is morally acceptable is solely determined by its consequences.
Patients disclose personal information because trust doctors to keep info confidential. Important patients disclose personal info => appropriate treatment. If doctors breached confidentiality, patients lose trust =>won’t disclose personal info.
Autonomy approach to confidentiality
Respecting autonomy fundamental principle- action not respect autonomy not morally acceptable whatever outcome (unless justifiable reason to limit autonomy)
Consider v important control who access personal info= expression of autonomy. Respecting autonomy = personal info confidential unless permission to disclose. Can override autonomy when serious harm to others.
Duty approach to autonomy
Certain actions morally required + others morally impermissible whatever outcome
When doctor gains personal info implied promise info kept confidential. Moral duty owed to all patients not to break promises. Wrong breach confidentiality unless given permission to disclose.
What is the overarching basic principle of confidentiality?
That information gained by a healthcare professional should not be divulged to others.
Based on case law, Data protection act
What are the 3 exceptions to confidentiality?
1) With patients consent
- Implied consent
- Express consent
2) Required by law
- required by statute
- assisting police
3) In wider public interest
Implied consent
Rather than express consent (patient says yes orally or in writing) imply that patient consents to us telling wider team about their condition through them being in hospital and realising that other people will be looking after them too
Express consent
Cannot rely on implied consent when breaching confidentiality to others not actively involved in patients care- must have express consent
Nature of info? How much info? Form of disclosure? To whom?
Most relatives don’t have rights unless:
- Parent of child not Gillick competent
- Consulting next of kin in situations of patient who lacks competence to make decision about healthcare
Required by statute
Statues= laws passed in parliaments
Examples of breach:
- Notification of death
- Notification of termination
- Treatment of drug addict with specified drugs
- Notifiable infectious disease
In these cases permission of patient NOT required => tell relevant authorities
Assisting police
General principle remains same. Exceptions:
- Under warrant from circuit judge
- Aid in police request in identifying drivers suspected of offences
(1988 road traffic act) - Aid police in all matters with suspected terrorist patient
Wider public interests
- Balance between duty to patient and duty to society
- Maybe challenged
- Must justify action or inaction
What are the laws regarding confidentiality in children <16?
Decision based on patients best interests
Child <16 NOT Gillick competent:
- Doctor can breach confidentiality if in best interests (or with parental consent)
Child <16 GILLICK competent:
- Gillick competent child can consent/refuse disclosure
- BUT confidentiality lawfully breached if in child’s best interests
What are the laws regarding confidentiality in children >16?
Child >16 presumed competent + disclosure only made with consent
- BUT confidentiality lawfully breached if in child’s best interests up to age 18
Generally not in best interests of competent child to override competent refusal
DVLA and confidentiality
Patient with condition that they should not be driving. encourage them to stop driving and tell them to inform DVLA. if they don’t and continue to drive = pose risk to others then can contact DVAl and inform patient have contacted them. Only disclose relevant info to medical advisor- not full diagnosis. Only relevant stuff
