ethical and legal duties

Question 1

what is an ethical and legal duty?

Answer 1

confidentiality

Question 2

why is confidentiality important?

Answer 2

if a patient feels they cannot control what is breached or thinks things are shared inappropriately will prevent them from coming back even if something serious is wrong

Question 3

when can confidentiality be breached?

Answer 3

required by law
patient consents
disclosure is of overall benefit to patient
justified in public interest

Question 4

what are the requirements if sharing information?

Answer 4

explicit patient consent
anonymisation 
minimum possible 
follow all relevant legal procedures 
patient has access to information and right to object

Question 5

what should disclosure be

Answer 5

prompt and must tell if not reasonably expect unless not practical

Question 6

what types of consent are there?

Answer 6

explicit - oral or verbal

implied - reasonable to assume the patient would allow it

Question 7

why might breach be in public’s best interest?

Answer 7

serious risk of harm, communicable disease or crime

Question 8

when would you proceed without consent?

Answer 8

if consent will prevent the prevention, detection or prosecution in crime

Question 9

what is considered when deciding whether to breach?

Answer 9

the potential harm to patient, and doctors, the harm to others if not, the benefits to individual or society, the nature of the information and patients views and whether harm can be avoided

Question 10

should patient be aware of breach?

Answer 10

if practical and safe to do so - even if without consent

Question 11

where would advice be sought?

Answer 11

caldicott or data guardian - keep identity hidden of patient

Question 12

what should be done when disclosing?

Answer 12

report reasons for doing so and steps taken to get consent or why not

Question 13

a condition may impact or transmit to healthcare workers - when would you not disclose this?

Answer 13

when there are already sufficient barriers in the system to protect them from this

Question 14

if you think a child is not being given full protection from a parent with a communicable decision how is it treated?

Answer 14

as a safeguarding issue

Question 15

what is the basis on which information can be shared to other HCPs?

Answer 15

need to know basis

Question 16

what are common breaches?

Answer 16

discussing patients in public spaces, with friends, at home, leaving computer unattended and leaving paper records lying where others can see them

Question 17

what are the reasons for duty of confidentiality?

Answer 17

ashamed of condition, stereotypes, HRA 1998 - respect for private and family life, people reluctant to seek care if not

Question 18

what are the limits of confidentiality?

Answer 18

moral obligation to public, prevent harm to others and ourselves, failure poses risk of harm or death, consider effect to everyone such as in Tarasoff case, need to know basis