Confidentiality

Question 1

What are the grounds for confidentiality in medical practice?

Answer 1

1) Respect for patient autonomy.
2) Implied promise.
3) Virtue ethics.
4) Consequentialism.

Question 2

What is confidentiality?

Answer 2

When one person discloses information to another and the person to whom the information is disclosed pledges not to divulge that information to a third party without the confiders permission.

Question 3

What is the principle of common law in regards to confidentiality?

Answer 3

That information given or obtained in confidence should not be used or disclosed further except in certain circumstances.

Question 4

What are some documents with law and guidance in regards to confidentiality?

Answer 4

1) Common law (and also human rights law).
2) Statutory regulations.
3) GMC guidance (confidentiality 2017).

Question 5

What are some common law justifications for breaking confidentiality?

Answer 5

• With the patients consent.
• Unable to seek the patient’s consent but in patients best interests.
• It is required by law.
• In the public interest.

Question 6

What counts as in public interest?

Answer 6

• Risk must be real and serious.
• Risk must be of physical harm.
• Must be to an identifiable individual.
• Disclosure must only be on a need-to-know basis.

Question 7

What are some cases where there was a duty to warn?

Answer 7

• W v Edgell imposes justification but not obligation.
• Tarasoff in the US (1969).
• Palmer v Tees Health Authority (UK 1998).

Question 8

What are some statutory requirements for disclosure of confidential information?

Answer 8

Criminal cases, Public health reasons, Abortions, Births & Deaths, Road traffic offences, Fertility treatment, Venereal diseases (limited), Suspicion of child abuse and Terrorism.

Question 9

What are the legal aspects of confidentiality?

Answer 9

1) Situations where law obliges.
2) Situations where law allows.
There is a balancing of public interests (NOT private).

Question 10

What are some situations where professional guidance on disclosure may be useful?

Answer 10

• Public interest.
• Risk of harm to patient or others.
• Driving against medical advice
• Crime.
• HIV/AIDS; GP & partner.

Question 11

What are some issues with genetic testing and confidentiality?

Answer 11

An individuals test result can reveal information about another family member i.e. Huntingtons chorea.
OR
Should employers or (medical) insurers have access to employees/clients genetic test results?