What counts as confidential info, GMC principles on appropriate/inappropriate breach situations Flashcards
Give 4 examples of confidential info?
Medical records
Audio/visual recordings
Patient details
Fact that they are your patient
If a clinician uses a patient case as an example, why could that be confidential info?
Details of patient’s specific diagnosis and treatment could make them identifiable to third-parties
Give 4 examples of where professional duty of confidentiality arises from?
Regulatory bodies eg. General Medical Council
Common law
Statute (act of parliament)
Employment contract
What is a statute?
Act of parliament
Why do GMC principles state that patient confidentiality is essential for the clinician-patient relationship?
Maintains trust in clinician-patient relationship
Give 2 reasons why trust in the clinician-patient relationship is important?
Patients are willing to seek medical attention
Patient give doctors relevant info to provide good care
Why does GMC state that appropriate info sharing is important?
Efficient provision of safety and care of individual patients and the wider community
Do GMC principles state that a clinician must always obtain patient consent to disclose confidential info?
Need patient consent, unless law allows/requires clinician to disclose info regardless of obtained consent
In situations where confidential info is inappropriately disclosed, is confidentiality still maintained?
No, there is breached confidentiality
How could an email containing confidential info cause a confidentiality breach?
Email is sent to wrong person who has similar address to correct patient
Give 2 examples of how confidential info could be lost or stolen in a hospital, causing a confidentiality breach?
Unencrypted memory stick
Ward handover notes
How could a confidentiality breach occur in public?
Casual conversation, notes containing identifiable info are left in public area
How could a confidentiality breach occur online?
Peer groups on social media, clinicians post identifiable info
How could patient enquiries lead to a confidentiality breach?
Their identity isn’t verified by security checks, so person might be mistaken as correct patient or given info without patient consent to share
If there is serious/persistent failure to follow GMC confidentiality principles, what are the 3 consequences for the doctor?
Risk of losing registration
Dismissal
Criminal prosecution
What 2 consequences does the employer face after a confidentiality breach?
Bad publicity
Financial penalty with civil claim
What GMC document provides advice for social media use by clinicians?
Doctors’ Use of Social Media (2013)
What GMC document provides guidance on maintaining child confidentiality?
0-18 ethics guide summary
If the child is aged 16-17, are the competent to consent to medical treatment?
They are presumably competent to give consent
Is a 16-17 yrs old child entitled to the same duty of confidentiality as an adult?
Yes
Where has the guidance for confidentiality of a 16 or under child come from?
Sexual heath and contraception cases
What does the guidance for children 16 or under confidentiality state?
They still are entitled to a duty of confidentiality
What assessment is done to evaluate if a child aged 16 or under can give consent for medical treatment?
Gillick competence assessment
What 3 qualities must a child aged 16 or under have to give consent for their treatment, according to Gillick competence assessment?
Enough intelligence, understanding, competence
If a child aged 16 or under is Gillick competent, how do their rights compare to parental rights?
Child’s right to confidentiality and confidential care is more important than any parental rights
If a child aged 16 or under is not Gillick competent, do they still have right to confidentiality?
Child is primarily owed confidentiality but they can’t give informed consent, so individual with parental responsibility is involved in decisions regarding child’s care
If a child aged 16 or under is not Gillick competent, who is involved in decisions about the child’s medical treatment?
Child
Individual with parental responsibility for child
If an adult lacks capacity, are they still owed duty of confidentiality?
Yes
If an adult lacks capacity, who else is involved in their decision-making, and 3 things what do they contribute?
Individuals involved in the patient’s care contribute their own values, beliefs, wishes
If an adult lacks capacity, what is the purpose of discussing and disclosing their confidential info?
Must be in the patient’s best interests
Do deceased patients still have consent?
Yes
If a living patient asks to keep their info confidential after their death, must this be obeyed?
Yes, disclosing info after death would still be a breach of confidentiality
Give 2 examples of when confidential info of a deceased patient can be disclosed?
Requested by law
To assist coroner
What are the 4 circumstances in which confidential info can be disclosed?
Patient’s best interests
Public interest
Statute or judge-ordered
Implied/express consent
When patient consent is obtained to disclose confidential info, what 3 factors must the patient agree with?
What info is being disclosed
Why the info is disclosed
Consequences of disclosure
If patients give implied consent to disclose confidential info, who does this entail?
Family and other healthcare members
If a patient wishes to not disclose their confidential info to other healthcare members, what is the clinician’s response?
Patient wish must be respected
In the patient’s best interests, give 2 examples of when confidentiality is breached?
Emergency situation
Patient lacks capacity to consent
When confidentiality is breached in the patient’s best interests, what is this act called?
Act of necessity
Give 4 examples of situations in which statute requires obligatory disclosure of confidential info?
Road traffic collisions
Notifiable disease
Human fertility
Cancer registries
When the GMC investigates a doctor’s fitness to practise, must their confidential info be disclosed?
Yes
In a NHS counter fraud investigation, why is there full disclosure of confidential info?
To identify fraud risks as accurately as possible
Give 3 examples of situations in which a judge can order disclosure of confidential info in a court of law?
Criminal proceedings
Child protection proceedings
Coroners’ court: examining violent and unnatural deaths
If a court witness is judge-ordered to disclose confidential info, will they face consequences for this breach?
No, this breach is privileged as the judge has requested it
In a trial, who determines the extent of confidential info that is disclosed?
Judge
In what type of circumstance can healthcare professionals disclose confidential info for public interest?
Exceptional circumstances
If there was a serious crime, why must healthcare professionals disclose confidential info?
Prevent crime and support crime investigation and detection
If healthcare professionals knew that a person was abusive, must they disclose confidential info of that person in public interest?
Yes, to prevent serious harm or abuse to others
If healthcare professionals have judged that achieved public good outweighs duty of confidentiality in an exceptional circumstance, what do they do?
Disclose the relevant confidential info in public interest
When confidential info is disclosed in public interest, how much info should be disclosed?
Relevant info to case details only
When decisions to disclose confidential info are made in public interest, are all the decisions equally important?
Yes, all decisions choosing disclosure must have their own merits
Why must healthcare professionals record any decisions made to disclose confidential info in public interest?
To show the exceptional circumstances under which decisions were made
Even if confidential info is disclosed in public interest, should consent still be gained?
Ideally yes
Give 2 situations in which public interest disclosure can be shared with police?
Serious harm to individuals
Serious harm to national security/public order
According to the Police and Criminal Evidence Act 1984, can police request disclosed confidential info for any case?
No, it must be a serious arrestable offence
According to the Police and Criminal Evidence Act 1984, what warrant is needed to obtain confidential info?
Special procedure warrant
According to the Police and Criminal Evidence Act 1984, who can order to disclose confidential info of a victim or suspect?
Circuit judge
