Confidentiality Flashcards
What are the grounds for confidentiality in medical practice?
Respect for patient autonomy
Implied promise
Virtue Ethics
Consequentialism
When is confidentiality present?
When one person discloses information to another, and the person the information is disclosed pledges not to divulge that information to a third party without the confider’s permission
Where are laws and guidance written on confidentiality?
Common law
Statue law
GMC
What are some common law justifications for breaking confidentiality?
With the patient’s consent
On prescription papers
Unable to seek the patient’s consent but in the patient’s best interests
Required by law
In patients best interest
What happened in the case of W vs Egdell 1989?
A prisoner who had killed 5 people made an application to a mental health tribunal to be transferred
Dr Egdell was sent to make a confidential opinion in his mental state
Dr Egdell decided W was still a danger to society so W’s application was withdrawn
Dr Egdell sent a copy of his report to the Medical director of the hospital and the Home office
The patient brought an action of breach of confidence
The Court of Appeal held that the breach was justified in the public interest on the grounds of protection of the public
What happened in the case of X vs Y 1988?
A Health Authority sought an injunction to prevent a national newspaper publishing the names of two practicing doctors who were receiving treatments for AIDS
The court decided to keep hospital records confidential
What do we mean by public interest?
Risk must be real and serious
Risk must be of physical harm
Identifiable individuals
Disclosure must only to be need to know basis
Is there a duty to warn?
There is a justification but no obligation
What are the statutory requirement for disclose of confidential information?
Criminal cases- including female genitalia mutilation
Public health reasons
Abortions
Births and deaths
Road traffic offences
Fertility treatment
Venereal diseases
Suspicion of child abuse
Terrorism
What is the GMC’s guidance on confidentiality?
Can disclose when;
Risk to public interest
Risk of harm to patient or others
Driving against medical advice
Crime
HIV/AIDS- GP and partner
Why does genetic testing raise concerns regarding confidentiality?
An individual’s test result can reveal information about a family member
Genetic privacy in regards to employers or insurers
What was the case between ABC v St George’s 2017?
Father had been diagnosed with Huntington’s
The doctors decided not to pass this onto his daughters despite them having a 50% of carrying the gene
After one of the daughters gave birth, she accidentally found out about her Father’s condition
She sued the hospital, lost at the high court
She then appealed and since, genetics have a special asterisk in regards to confidentiality
Should you tell the patient’s spouse about them having HIV?
No
