Consent, privacy & confidentiality

Question 1

Components of valid consent

Answer 1

VIC-UP

• Voluntary (extreme stress may be a coercive factor)
• Informed
• Capacity
• Understand, retain, weigh up, communicate information
• Provides written/verbal/non-verbal consent

Question 2

Factors when weighing up breaching confidentiality and avoiding PREVENTABLE harm

Answer 2

• Likelihood of harm occurring
• Severity of harm
• Harm to patient due to confidentiality breach
• Likelihood that confidentiality breach will prevent harm from occurring

Question 3

Substitute decision makers

Answer 3

1. Advanced care directive
2. Medical treatment decision maker/power of attorney
3. Next of kin

Question 4

Types of torts (if consent not obtained)

Answer 4

Battery: intentional contact with another’s body w/o consent

Assault: same as battery, usually interpreted as sexual/indecent

Question 4

Situations when you may waive the obligation to obtain consent

Answer 4

EMERGENCY TREATMENTS, classified as necessary to:

• Save their life
• Prevent further damage to health
• Prevent significant pain/distress

Treatment must be something a REASONABLE person would consent to

Question 5

Patients who do not wish to be informed

Answer 5

• Should still be told the basic nature of the procedure
• Unwillingness to be informed must be RECORDED
• Tell patient that doctor may not be liable if things go wrong

Question 6

Privacy

Answer 6

Collection, use, disclosure, storage and access to identifiable patient information

Question 7

Relative de-identifiability

Answer 7

In a case where you have 1 old patient and 10 young patients, saying “old patient” is not de-identifying

Question 8

Confidentiality

Answer 8

Obligation to keep identifiable patient information secret

Question 9

Use of patient information

Answer 9

• Must be for the primary purpose for which it was collected
• Consent must be obtained initially, not every time
• Not required if there is a secondary purpose linked to the primary purpose which the patient may REASONABLY expect

Question 10

Disclosure of information

Answer 10

LEGALLY PERMITTED/MAY DISCLOSE IF:
- Patient consented
- De-identified information
- Interest of public health
- Sharing within health team (primary & secondary uses)
- Patient poses danger to themselves or others

LEGALLY REQUIRED/MUST DISCLOSE IF:
- Notifiable disease
- Medical malpractice
- Required by court/police
- Reportable death
- Child abuse
- Serious threat to public safety