Ethics - Confidentiality

From CambridgeNotes

  • General legal obligation (mostly common law, some statutes for special cases) – under "public interest"
  • No Breach of confidentiality if (a) patient gives consent or if (b) patient cannot be identified

GMC guidelines: - no force of law

  • Seek consent, anonymize data, keep disclosure minimum
  • Disclosure within teams usually not need express consent, just make sure pt aware, check no objections
  • If consequences to patient – almost always obtain consent
  • If no consequence to patient – obtain consent unless not practicable e.g. study from notes

Don’ts: Don’t lie e.g. deny HIV test on insurance form

  • Obviously don’t do it casually/for fun!
  • In minor crime or to prevent minor harm in someone else
  • GUM clinic – no info to 3rd party identifying patient (usually)
  • Should not write report/fill in form (e.g. insurance) disclosing confidential info without patient’s consent (written?)

Can breach: Society outweighs individual

  • Sharing information with healthcare team in pt interests
  • Driving when not supposed to (tell DVLA officer)
  • 3rd party has risk of significant harm e.g. HIV +ve spouse
  • Risk of serious crime - breach justified, but generally inform patient before disclosure

Must Breach:

  • Notifiable disease – Public Health (control of disease) Act 1984
  • Termination of pregnancy – Abortion Act 1967
  • Births, Deaths – Births and Deaths Registration Act 1953
  • Police on request (name and address of patient guilty of road traffic offences); signed search warrant; court orders
  • NB: looking up your own notes is illegal?!