Confidentiality

Question 1

List 4 things that confidentiality promotes (why is confidentiality needed?).

Answer 1

1 - Trust.

2 - Recognition of power imbalances.

3 - Patient life outside a medical context.

4 - Autonomy.

Question 2

What is therapeutic privilege?

Answer 2

• AKA therapeutic nondisclosure.
• The withholding of relevant information from a patient if nondisclosure is believed to be in the best interest of the patient.

Question 3

What happened in the X v Y 1988 case?

Answer 3

• A newspaper was to publish info on 2 doctors practicing as GPs with AIDS.
• The court ruled that it was not in the public’s best interest to know, as it was anticipated that the general public would not want to be tested if the precedent was set to disclose.

Question 4

What happened in the W v Egdell 1989 case?

Answer 4

• An arsonist was up for conditional discharge.
• A private psychiatric report said that he was not fit for release.
• The psychiatrist reported to home secretary.
• The court upheld the psychiatrist breaching W’s confidentiality in public interest.

Question 5

List 6 GMC exceptions to the duty of maintaining confidentiality.

Answer 5

1 - With the patient’s consent.

2 - Within healthcare teams.

3 - For the best interest of the patient’s medical care.

4 - For the best interest of others.

5 - For legal and statutory requirements.

6 - For teaching / audit purposes.

Question 6

List 2 deontological reasons to maintain confidentiality.

Answer 6

1 - Respect for autonomy.

2 - The patient is in control of their information.

Question 7

List 2 utilitarian reasons to breach confidentiality.

Answer 7

1 - Greater good for a greater number of people.

2 - Weighing up expected harms and benefits.

*In general, utilitarianism will favour maintaining confidentiality.

Question 8

What is the difference between deontology and utilitarianism?

Answer 8

• According to deontology, the morality of an action is based on whether that action is right or wrong under a series of rules.
• According to utilitarianism, the morality of an action is based on the consequences of that action.

Question 9

List 2 utilitarian reasons to maintain confidentiality.

Answer 9

1 - Increases chances of compliance.

2 - Decreases risk of others being put at risk if the patient trusts and stays with you.