Confidentiality Ethics

Question 1

Describe the consequentialist approach to confidentiality

Answer 1

Whether an action is morally acceptable is determined by its consequences

Patients will disclose information because they trust doctors to keep their information confidential
This is needed so doctors can treat them appropriately
If confidentiality was breached => patients would lose trust and patients will be unwilling to disclose their information

Question 2

What are the problems with the consequentialist argument

Answer 2

You may be wrong about the consequences
Ignores your duty to your patient
Permits doctors to breach confidentiality whenever as long as the patient doesn’t find out

Question 3

Describe the autonomy approach to confidentiality

Answer 3

Respecting autonomy should be seen as a fundamental principle in medical ethics
Therefore an action that does not respect autonomy is not morally acceptable whatever the outcome (unless there is a justifiable reason for limiting autonomy)

Individuals consider it very important that they control who has access to their personal information
So control over one’s personal information is an expression of autonomy
So respecting autonomy requires us to keep personal information confidential unless we are given permission to disclose
However, it is possible to override autonomy when there is serious and real harm to others

Question 4

What are the problems with the autonomy argument

Answer 4

What constitutes serious harm

This assumes everyone has autonomy, which they don’t
-infants, young children
-adults lacking capacity
-dead patients
By this logic, you don’t respect the autonomy of these individuals

Question 5

Describe the duty approach to confidentiality

Answer 5

Certain actions are morally required and others a morally impermissible whatever the outcome

When a doctor gains personal information about a patient, there is an implied promise that this information will be kept confidential
There is a moral duty not to break promises, this is owed to all your patients
So it it wrong to breach confidentiality unless we are given permission to disclose

Question 6

What are the problems with the duty approach to confidentiality

Answer 6

This approach is problematic in
-serious crime
-suspected child abuse
The 2 parties to the promise of confidentiality are the doctor and the patient
-the doctor is a public servant
-the patient is a public citizen
-the patient has a moral duty not to commit serious crime
If the patient commits a serious crime, he would have breached the terms of this promise, making it ok to break confidentiality?

This doesn’t work for patients who lack capacity

• the doctor also has an overriding duty to act in their best interests
• so personal information can be disclosed when it is in the best interests of someone lacking autonomy
• but it will usually be in the patient’s best interests to only disclose to those involved in the patients care