Topic 7: confidentiality Flashcards
What information is confidential?
- Identifiable information
- Clinical information on diagnosis/treatment
- Images of patient
- Who the doctor is
Describe doctor-patient relationship
- Precondition in sharing personal information = confidential
- Vital for accurate diagnosis + effective treatment
- Breaking confidentiality = breaking promise to patient
Describe the legal regulation of confidentiality
- Conditions that establish duty of confidentiality
1) Info must have inherent quality of confidentiality = personal data
2) Info given in clinical context
3) Unauthorised disclosure would cause harm
Give the types of legal frameworks
- USA = HIPAA
- EU = GDPR = controls how personal info is used + keeps data safe
- UK = Human rights act 1998 + GDPR + Health/Social care act
What are secondary uses of information?
- In medical research = prior consent
- Clinical audit = implied consent
- Conference + educational publication = prior consent
When is confidentiality commonly breached?
- Access of nurses + students of records
- Interpreters
- Info shared with proxy
- Info shared with family of patient in critical care
When is confidentiality accidentally breached?
- Crowded places = lifts/canteen
- Close proximity = A&E/wards
- Patient notes left open
- Computers + printed info
What are the limits to confidentiality?
- Ethical to disclose info when patient consents + imminent threat of harm to patient or others
Give justifications for breaking confidentiality
1) Patient consents = to team + family
2) In best interest = proxy
3) In public interest
4) Required by law
Give when breaking confidentiality is required by law
- DVLA = informed if someone is unfit to drive
- Child protective services = in child abuse cases
- Police = someone with GSW/knife wounds
- Patient requests police = serious crime
Describe confidentiality for a sexually active minor
- Difficult to differentiate between abuse vs consent
- Fear of confidentiality can deter some teenagers from seeking advice
Describe confidentiality for communicable disease
- Doctor must notify authorities if infection disease
- AIDS/HIV not notifiable
- Disclose to partner in public interest
Explain how to disclose information about patient
1) Use anonymous information if practical
2) Provide the patient how their info will be used
3) Get explicit consent if identifiable info to be disclosed
4) Keep disclosure to minimum
5) Follow relevant legal requirements
Describe confidentiality after death
- Ethical duty continues
- Only disclose if:
> Legally = death certificate
> Relatives
> Clinical audit
> Access to health records
