Confidentiality

Question 1

What are the principles & processes of obtaining informed consent?

Answer 1

• Client doesn’t speak/not literate in primary language used in practice:
  ○ Detailed verbal explanation or arranging for qualified interpreter/translator
  
  • Lacking capacity for informed consent
    ○ Seek permission from appropriate 3rd party, informing consistent with client’s level of understanding
    ○ Ensure 3rd party acts according to client’s wishes
    ○ Take reasonable steps to enhance client’s ability to give informed consent
  • Using electronic services - computer, phone, radio, TV
    ○ Inform recipients of limitations & risks associated with services
  • Obtain informed consent before audiotaping/videotaping clients or permitting observation of services to a 3rd party
  • When SW acts on behalf of clients who lack capacity, take reasonable steps to safeguard interests & rights
  • To obtain informed consent - use clear understandable language related to services, risks, limits, time frame, & right to refusal/withdrawal
  • If a client lacks capacity or is a minor
    informed consent must be obtained by responsible 3rd party & assent obtained from client

Question 2

How can a SW use a client record?

Answer 2

• Should provide clients with reasonable access to their records
  
  • If there is concern that access to records could result in serious misunderstanding or harm - should provide assistance in interpreting records & consultation regarding records
  • Limit access to records or portions ONLY in exceptional circumstances when there is compelling evidence that such access would cause serious harm
  • Both client request & rationale for withholding should be documented in client’s files as well
  • Should protect confidentiality of other individuals identified or discussed in records (redacted)
    Only solicit info essential for providing services

Question 3

When do standards of confidentiality apply?

Answer 3

As soon as private info is shared

Question 4

When can a SW disclose confidential information?

Answer 4

• May disclose confidential information when appropriate with valid consent from client/person legally authorized to consent on behalf of client
  
  • Expectation that SW will keep info confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person
  • Disclose least amount of info necessary to achieve purpose
  • Should inform clients - to extent possible - about disclosure of confidential info & potential consequences before disclosure is made
    
    • Applies whether basis is of a legal requirement or client consent
    • Do not disclose confidential info to 3rd party payers unless clients have authorized such disclosure

Question 5

What does a SW do about disclosing when working with groups/families?

Answer 5

• When working with groups/couples/families – seek agreement among involved parties concerning each person’s right to confidentiality and obligation to preserve confidentiality
  Including informing that SW cannot guarantee that each participants honour such agreements

Question 6

What are SW responsibilities in legal proceedings re: confidentiality?

Answer 6

• Protect Confidentiality in legal proceedings to extent permitted by law
  When a court of law/other legally authorized body orders SW to disclose confidential/privileged info that might harm a client - SW should request that the court withdraw the order or limit the order as narrowly as possible or maintain records under seal unavailable for public inspection

Question 7

Are subpoena’s are court orders the same?

Answer 7

• Subpoena & court order are not the same
  ○ When receiving a subpoena, a SW should respond and claim privilege but not turn over records unless asked to
  When a SW gets a court order they should try to limit its scope/ask that the records be sealed

Question 8

What are other instances when SW needs to protect client confidentiality?

Answer 8

• Protect client confidentiality when responding to media requests
  
  • Protect confidentiality of written & electronic records & other sensitive info
  • Take precautions to ensure and maintain confidentiality in emails, fax, phones, answering machines, other electronic/computer technology
  • Disclosure of identifying info should be avoided whenever possible
  • Should transfer & dispose of records consistent with provincial law & social work licensure
  • Do not disclose identifying info when discussing clients for teaching or training purposes unless a client has consented to disclosure
  • Don’t discuss identifying info when discussing clients with consultant unless a client has consented or there is compelling need

Question 9

What does a SW do in regards to confidentiality of minors?

Answer 9

○ Parents may have access depending on age & type of treatment/setting
In treating minors with parents who have joint/limited custody must also be aware of rights of all parties to access/consent to release