Truth telling and Confidentiality Flashcards
Utilitarianism
A branch of consequentialism, considers an action to be right or wrong depending on the outcome, rather than the act itself. The best outcome maximises happiness and minimises suffering for the most people possible.
Deontological ethics
Duty-based ethics, considers an action to be inherently right or wrong, regardless of the outcome.
Ross’ 7 duties
- fidelity
- reparation
- gratitude
- justice
- beneficence
- self-improvement
- non-maleficence
4 pillars of medical ethics
Beneficence, non-maleficence, autonomy and justice.
Virtue ethics
Based on cultivating a moral character (right values) and phronesis (practical wisdom). Often based around a mentor or role model.
Why tell the truth?
Utilitarianism: if it increases happiness, or diminishes suffering
Deontology: because it’s your duty
Virtue: because it’s what a good person would do
Trust
Honesty is required for trust, which in turn is required for society to function.
The Francis Report
Investigation into the Mid Staffs scandal, an ethical failure within the NHS. Patients were treated with neglect and abuse, leading to hundreds of excess deaths.
The duty of candour
Be honest with your patients about mistakes or errors that have happened in their care.
Confidentiality
Keeping any information that is learned in the context of the doctor/patient relationship private (as long as it’s safe and appropriate).
Legal basis of confidentiality
Confidentiality comes from the Common Law, and there is no single act of legislation that enforces it. Any information about a patient that you know because you are their doctor is confidential, although anonymised information can be shared in certain cases.
Sharing anonymised information
Patient data that does not contain any identifying information can be used for the purposes of research, publication, teaching and third-party requests. Consent is required.
Legal breaches of confidentiality
To establish a legal breach:
- the information must have been confidential
- the information must have been gained in confidential circumstances
- it must be proven that there was unauthorised use of the information
A successful case would also prove that the breach was harmful, although it does not have to have been intentional.
Breaching confidentiality
Confidentiality can be breached when disclosure is required by law, or is in the best interest of the public/patient. Consent is not required, although the patient should be informed first unless this would be counter-productive.
The Data Protection Act (2018)
Legislation relating to all healthcare records (paper and electronic) of living patients. The NHS is the owner of all medical records, and is accountable for following the Act. Patients have the right to access their records on request, although this may be refused in certain circumstances.
