week 4: trust and privacy Flashcards
how trust in doctors plays a role
- if we want to benefit from medical interventions you need to trust the doctors
- some of the medical benefits will require it, yield to the advice of their physicians
- nature of illness makes patients vulnerable and reliant on trusting their doctors
- doctorly character is an essential element of the commitement to medicine and it defines distinctive virtues
what is privacy
a person has the right to control what happens with information about themselves
- they are in control of what they share
- persons have privacy interests in relation to their bodies, personal info, thoughts and opinions
- focus on the individual
- what you sharw with the physician/medical team
privacy breach
when a persons confidential information has been accessed by an unauthorized individual without the persons approval
confidentiality
- refers to safeguarding information about a person
- a duty of the provider to protect PHI from being shared without prior authorization
- this onus is placed on the health information custodian
- personal health information act
directly identifying information
the information identifies a specific individual through direct identifiers (name, social insurance #, personal health number)
indirectly identifying information
the information can reasonably be expected to identify an individual through a combination of indirect identifiers (DOB, place of residence, unique personal characteristic, age)
coded information
direct identifiers are removed from the information and replaced with a code. depending on access to the code, it may be possible to re identify specific participants
anonymized information
the info is irrevocably stripped of direct identifiers, a code is not kept to allow future re linkage and risk of reidentification of individuals from remaining indirect identifiers is low or very low
anonymous infromation
the information never had identifiers associated with it (e.g. anonymous surveys) and risk of identification of individuals is low or very low
PHI - collection
- the collection of PHI is permitted if it is required for the provision of health related surfaces
- one should only collect the minimal amount of PHI that is necessary to meet the healthcare needs of the patient
- consent should be sought for collection
- often implied
PHI - use
- PHI may be used to fulfill the purpose defined when it was initially collected
- Consent for the collection of one’s
PHI was obtained for the purpose of . . . [use] - To support the planning, evaluation,
and monitoring to support the delivery of health services offered by the custodian. - Quality improvement.
- For educating agents to provide care.
PHI - Disclosure
- Generally, PHI may be disclosed when it is
necessary for the provision of health care
consent should always be obtained - To contact potential SDM’s if the patient is
incapable. - To determine eligibility of other health services funded by Ontario.
- For the purposes of an official audit
Circle of care
- each provider in the circle of care will know different things
- you should only be looking at information thats relevant for you to know, using your own clinical/professional judgement
is at ethicist within the circle of care
- Bringing too many people in when not needed could be problematic
- Only utilize a consult when there is a need for one
- Do you need consent?
- Patient doesn’t have to interact directly to them
- Providing more support to the doctor, physician, nurses etc
- Dependent on what information they need
- Have a huge amount of INFLUENCE but not necessarily sole decision making
permissive reporting
there are circumstances where the disclosure of PI is permitted by law or based in professionalism and ethics
MUST BE ALL 3:
- there is a clear risk to an identifiable person or group
- risk of serious body harm or death
- danger is imminent
Discussion: Case 5
look at slides posted online
