Medical Confidentiality Flashcards Preview

Year 3 - Medical Ethics and Law > Medical Confidentiality > Flashcards

Flashcards in Medical Confidentiality Deck (18)
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1
Q

what is confidentiality?

A

Confidential - Adj; intended to be kept secret

Confidentiality - Noun; the state of keeping or being kept secret or private

2
Q

what is the The Hippocratic Oath?

A
  • Written by Hippocrates in about 450 BC
  • Described the basic ethics of medical practice and laid down a moral code of conduct for doctors
  • The code does contain certain sentiments which might be considered outdated
  • Many people think that doctors still swear the Hippocratic Oath – it is not compulsory!
  • The British Medical Association (BMA) drafted a new Hippocratic Oath for consideration by the World Medical Association in 1997 but it was not accepted and there is still no one single modern accepted version
  • In the UK, the closest to a modern Hippocratic Oath are the core values and principles set by the GMC, laid out as the duties of a doctor under the title “Good Medical Practice”
3
Q

The Hippocratic Oath is a a solemn promise of what?

A
  • Of solidarity with teachers and other physicians
  • Of beneficence (to do good or avoid evil) and non-maleficence (‘do no harm’) towards patients. (In fact the well-known “first do no harm” phrase does not feature in the classical Hippocratic Oath.)
  • Not to assist suicide or abortion
  • To leave surgery to surgeons
  • Not to harm, especially not to seduce patients
  • To maintain confidentiality and never to gossip
4
Q

The code lays heavy emphasis on what?

A

confidentiality and respect for patients

The Classical version rather vividly states: “I will abstain from … the seduction of females, or males, of freemen or slaves” whereas modern versions say “I will be honest, respectful and compassionate

5
Q

whata re the four domains of GMC: Good Medical Practice?

A
  1. Knowledge, skills and performance
  2. Safety and quality
  3. Communication, partnership and teamwork
  4. Maintaining trust
6
Q

What comes under Domain 4. Maintaining trust of GMC: Good Medical Practice?

A

Show respect for patients

Treat patients as individuals and respect their dignity

Treat patients politely and considerately

Respect patients’ right to confidentiality

Treat patients and colleagues fairly and without discrimination

Act with honesty and integrity

Never abuse your patients’ trust in you or the public’s trust in the profession

7
Q

in medical terms, why is trust important?

A

trust is an essential part of the doctor-patient relationship and professional confidentiality (secrecy) is central to this

8
Q

What may happen if patients dont trust doctors?

A

Patients may avoid seeking medical help, or may under-report symptoms, if they think their personal information will be disclosed by doctors without consent, or without the chance to have some control over the timing or amount of information shared

9
Q

Doctors are under both _____ and _____ duties to protect patients’ personal information from improper __________

But appropriate _________ sharing is an essential part of the provision of safe and effective ____

Patients may be put at risk if those who are providing their care do not have access to _______, _______ and __-__-____ information about them

A

ethical and legal

disclosure

information

care

relevant, accurate and up-to-date information

10
Q

What happens if confidentiality is breached?

A

Medical confidentiality is based on the law of contract and equity

Breach of confidentiality constitutes Breach of Contract

If the patient can demonstrate the he has suffered harm in the civil courts, reparative damages will be awarded against the doctor

11
Q

what is the common law?

A

Information acquired by doctors in their professional capacity will generally be confidential under the common law. This duty is derived from a series of court judgments, which have established the principle that information given or obtained in confidence should not be used or disclosed further except in certain circumstances. This means a doctor must not disclose confidential information, unless there is a legal basis for doing so.

12
Q

What is the The New General Data Protection Regulations?

A

The GDPR is based around six data protection principles and provides a range of rights for individuals.

The GDPR defines personal data as:
‘any information relating to an identified or identifiable natural person (‘data subject’); an identifiable natural person is one who can be identified, directly or indirectly, in particular by reference to an identifier such as a name, an identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that natural person’

13
Q

GDPR - The data protection principles state that personal data must:

A

Be processed lawfully, fairly and in a transparent manner

Be processed for specified, explicit and legitimate purposes and not in any manner incompatible with those purposes

Be adequate, relevant and limited to what is necessary in relation to the purposes

Be accurate and up to date

Must not be kept for longer than is necessary

Be secure

14
Q

The advice in this guidance is underpinned by what following eight principles?

A

a) Use the minimum necessary personal information
b) Manage and protect information
c) Be aware of your responsibilities
d) Comply with the law
e) Share relevant information for direct care
f) Ask for explicit consent
g) Tell patients
h) Support patients to access their information

15
Q

GDPR for doctors:

Where special category data are being used, at least one of the conditions in Article 9 must also be met. Information on a patient’s health record is likely to be special category data for the purposes of the GDPR. The conditions most likely to be relevant in medical practice are that:

A

The data subject has given explicit consent (Article 9(2)(a))

The processing is necessary to protect the vital interests of the data subject or another person in a case where the data subject is physically or legally incapable of giving consent (Article 9(2)(c))

The processing is necessary for reasons of substantial public interest (Article 9(2)(g))

The processing is necessary for reasons of public interest in the area of public health (Article 9(2)(i)

The processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes (Article 9(2)(j))

16
Q

GDPR for doctors:

should doctors always rely on consent under GDPR?

A

It will not always be appropriate for data controllers to rely on consent under GDPR as a condition for processing health data. For example, implied consent is an accepted concept under the law of confidentiality, but it is unlikely to be a sufficient basis for sharing personal data based on consent under Article 6(1)(a) of the GDPR, and will not be sufficient for sharing ‘special category data’ based on explicit consent under Article 9(2)(a) of the GDPR

However, the GDPR does provide alternative conditions for processing data which are likely to be more appropriate in a health context

This means that a doctor who is a data controller may be relying on different legal justifications for disclosing information under the common law duty of confidence and not under the GDPR. It also means that doctors can continue to share information on the basis of implied consent if the conditions set out for direct care and for local clinical audit are met

17
Q

Situations in which confidentiality can be breached…..

A

Confidentiality is an important ethical and legal duty but it is not absolute:

  1. With the patient’s consent
  2. With other medical practitioners in the patient’s interest
  3. In the doctors own defence
  4. Statutory requirements – prevention, detection and prosecution of serious crime
  5. When directed to by a court of law
  6. Protection of other persons
  7. In the public interest (terrorism, murder, culpable homicide, rape)
  8. Child abuse
18
Q

Whata re good sources of advice?

A
  • Caldicott or data guardians are senior people in the NHS, local authority social care services, and partner organisations, who are responsible for protecting the confidentiality of patient information and enabling appropriate information sharing
  • Data protection officers have a statutory function under the General Data Protection Regulation to monitor a data controller’s compliance with the GDPR