Confidentiality and Children 2

Question 1

What age can consent?

Answer 1

• Age of consent is 16
• Family law act 1969
• Gillick exception

Question 2

Who consents on behalf of children?

Answer 2

Parental responsibility (need one person to consent)

• Parents (if married or on birth certificate)
• Mother (if unmarried and no agreement)
• Legally appointed guardian
• Local authority with a care or protection order

Question 3

List fraser/ gillick principles

Answer 3

• Girl understands the doctors advice
• He cannot persuade her to involve parents
• She is very likely to have sex regardless of whether she gets contraception or not
• Unless she gets contraception her physical or mental health or both will suffer
• It is in her best interests regardless of parental consent

Question 4

Can children refuse treatment?

Answer 4

• Children cannot refuse treatment
• Gillick is about best interests
• If under 16 no court order needed, if 16-17 court order needed unless agreement obtained
• Can be overruled if competency rebutted due to mental condition

Question 5

Summarise children and treatment

Answer 5

• As you get older, increasing autonomy
• Over 16 can accept treatment, parents cannot accept for them
• Treatment refusal cannot occur until 18 years, court can go against it
• Oral permission must be acquired from either parent if child is at school for example and it is non-urgent
• Surgeon should do surgery under emergency circumstances as it is in the child’s best interest

Question 6

Define confidentiality

Answer 6

Information gleaned by a healthcare professional should not be divulged to others

Question 7

List exceptions for confidentiality

Answer 7

• MDT (implied consent by presence, who is part of the team)
• If the patient agrees to have information shared. Relatives do not have rights, and you need to find out which info patients want to be shared.
• That required by law (notification of death, notification of termination, treatment of addicts, notifiable infectious disease. RTA, prevention of terrorism)
• Assisting the police (under a warrant from a judge, to aid police request in identifying drivers suspected of offenses, to aid police in all matters with suspected terrorist patient)

Question 8

Describe GMC stance on confidentiality

Answer 8

• All confidences must be respected
• Consent by the patient is the primary exception
• But, where there is a risk of serious harm or death to the patient or another there is disclosure
• There is no obligation to be confidential if identity is not revealed

Question 9

What is the Caldicott Guardian?

Answer 9

• Work in a hospital
• Act as the conscience of an organisation
• Responsible for holding confidentiality of the patient

Question 10

List the caldicott principles

Answer 10

• One should justify the purpose of holding patient
  information.
• Information on patients should only be held if
  absolutely necessary.
• Use only the minimum of information that is required.
• Information access should be on a strict need to
  know basis.
• Everyone in the organisation should be aware of their responsibilities.
• The organisation should understand and comply
  with the law

Question 11

Describe Bluck case

Answer 11

• Mrs KD died after childbirth
• Mother asked for hospital notes to find out what happend and was refused due to husband
• Public interest in maintaining confidentiality outweighed public interest
• Husband would have been able to sue the hospital if info was disclosed

Question 12

Describe Bluck case

Answer 12

• Mrs KD died after childbirth
• Mother asked for hospital notes to find out what happend and was refused due to husband
• Private interest in maintaining confidentiality outweighed public interest
• Husband would have been able to sue the hospital if info was disclosed

Question 13

How is confidentiality acquired in publication?

Answer 13

• Signed written paper from a patient
• Can be published if fully anonymised and patient cant be identified
• Can also get consent from the family

Question 14

How is confidentiality acquired in publication?

Answer 14

• Signed written paper from a patient
• Can be published if fully anonymised and patient cant be identified
• Can also get consent from the family

Question 15

Describe confidentiality in children

Answer 15

• Best interests
• Can breach if under 16 and not gillick competent. Then needed from patent
• If is competent, can refuse or give consent to disclosure. However can be overruled if not in best interests

Question 16

List the GDPR principles

Answer 16

• Processed lawfully
• Collected for legitimate purposes
• Adequate and relevant for what is necessary
• Accurate and kept up to date
• Storage limitation
• Stored safely and confidentiality

Question 17

List individual rights due to GDPR

Answer 17

• Right to be informed
• Right of access
• Right to rectification
• Right to erasure
• Right to restrict processing
• Right to data portability
• Right to object

Question 18

What if family dont want something on the death certificate?

Answer 18

Talk to the coroner (a legal expert)

Question 19

What does road traffic act say?

Answer 19

• Must give the name and address to identify the patient

- No need to assist the police (eg. say they have been drinking alcohol)

Question 20

What is done if patient refuses to stop driving?

Answer 20

• Tell DVLA and patient

- No informing employer