Data Protection & Confidentiality Flashcards
What is the consequentialist argument for maintaining confidentiality?
- Impact on patient (e.g. breach may upset them, affect trust + make them less likely to share info in future)
- Impact on others generally (e.g. loss of public trust so less effective care for many)
- Impact on specific others (e.g. harm of non-disclosure)
What other reasons are there to maintain confidentiality?
- Respect for autonomy: self-determination includes determining how info about oneself is used, how or whether its shared
- Virtue ethics: promise-keeping + trustworthiness are virtues
- Other duties: duty of care (data shared within healthcare team but not beyond) + patient-dr relationship
We must make sure any personal information that we hold or control is effectively protected at all times against 3 things, what are they?
- Improper access
- Disclosure
- Loss
When can you share a information about a patient’s care?
CONSENT (implied or explicit)
When is implied consent be sufficient?
- Data being accessed to support a patient’s direct care
- Info available to patients about how data will be used + how they can object
- No reason to believe they would object
- Satisfied that anyone you disclose info to will understand it is given to them in confidence, treating it accordingly
When should you seek explicit consent before sharing a patients information?
If you suspect a patient would be surprised to learn about how you are accessing or disclosing their personal information
What are some examples of uses of information not directly relevant to a person’s medical care when you should seek consent?
Research Certain types of audit (e.g. financial or local clinical) Public health Education Health service planning
When can you disclose personal information for secondary purposes without gaining consent?
- Required by law
- Approved through a statutory process that sets aside common law of confidentiality
- Justified in public interest
- Not appropriate/practicable to obtain consent
BUT consent should always be sought where possible
____ information will normally be sufficient for secondary purposes.
Anonymised - only disclose identifiable info if there is a legal basis for breaching confidentiality
When is data considered anonymised?
- Does not directly identify any individual
2. Unlikely to allow any individual to be identified through combination with other data
What must be considered when anonymising information?
Different types of data will have different levels of re-identification risk e.g. small vs large dataset - bare in mind context and who you are showing data too
What is pseudonymised data?
There will be a way of linking the data back to original records using a unique patient identifier - data management and de-identification process by which personally identifiable info fields within a data record are replaced by 1 or more artificial identifiers (pseudonyms) i.e. CODED info
What can you do as a researcher to avoid breaching confidentiality?
Get patients to contact you directly so they volunteer their information voluntarily - cannot then tell clinician who has agreed to be involved in trial w/o consent
When deciding whether the public interest in disclosing information outweighs patient’s and public interest in keep it confidential, you must consider:
- Potential harm/distress to patient arising from disclosure
- Potential harm to trust in Drs generally
- Potential harm to others if info is not disclosed
- Potential benefits to individual/society arising from info disclosure
- Nature of info to be disclosed + views expressed by patient
- Whether harms can be avoided or benefits gained w/o breaching patient’s privacy or with min intrusion
Who has to approve the disclosure of identifiable information in research cases?
Research Ethics Committee (REC)
