Podcast
Questions and Answers
What is the foundation of trust in the doctor-patient relationship, according to ethical principles?
What is the foundation of trust in the doctor-patient relationship, according to ethical principles?
- The legal obligation to provide care.
- The doctor's expertise in diagnosis.
- The confidentiality of patient information. (correct)
- The patient's ability to pay for treatment.
Which of the following best describes the scope of patient information that is subject to the duty of confidentiality?
Which of the following best describes the scope of patient information that is subject to the duty of confidentiality?
- Only clinical information related to diagnosis and treatment.
- Only information that patients explicitly designate as confidential.
- All identifiable patient information, regardless of how it is stored or recorded. (correct)
- Only written and computerized information.
From an ethics standpoint, what is the primary significance of patient autonomy in the context of confidentiality?
From an ethics standpoint, what is the primary significance of patient autonomy in the context of confidentiality?
- It ensures doctors can practice without interference.
- It affirms the patient's right to control their personal information. (correct)
- It provides a legal framework for data protection.
- It supports the doctor's decision-making authority.
In what way does the legal framework in the UK protect patient confidentiality?
In what way does the legal framework in the UK protect patient confidentiality?
Which factor would be most important when evaluating whether to use patient data for medical research?
Which factor would be most important when evaluating whether to use patient data for medical research?
Which scenario represents a common breach of patient confidentiality?
Which scenario represents a common breach of patient confidentiality?
What is the most important consideration in avoiding accidental breaches of patient confidentiality?
What is the most important consideration in avoiding accidental breaches of patient confidentiality?
What extends to social networking sites regarding guidelines for patient confidentiality?
What extends to social networking sites regarding guidelines for patient confidentiality?
How are medical students held regarding patient confidentiality?
How are medical students held regarding patient confidentiality?
In what situation might breaching patient confidentiality be ethically justified?
In what situation might breaching patient confidentiality be ethically justified?
What consideration should be paramount when deciding whether to breach confidentiality in the public interest?
What consideration should be paramount when deciding whether to breach confidentiality in the public interest?
Under UK law, in which of these situations is breaching patient confidentiality legally required?
Under UK law, in which of these situations is breaching patient confidentiality legally required?
What should a doctor do if they have a patient who is medically unfit to drive?
What should a doctor do if they have a patient who is medically unfit to drive?
In handling a minor who is sexually active, what presents an especially difficult ethical area?
In handling a minor who is sexually active, what presents an especially difficult ethical area?
When can you breach confidentiality against a child's wishes?
When can you breach confidentiality against a child's wishes?
Under what circumstance is a doctor required to notify a local authority officer?
Under what circumstance is a doctor required to notify a local authority officer?
Beyond the moral duty to maintain confidentiality, doctors also have a legal duty. Which of the following scenarios best exemplifies this legal duty?
Beyond the moral duty to maintain confidentiality, doctors also have a legal duty. Which of the following scenarios best exemplifies this legal duty?
What is the most precise definition of 'identifiable patient information' that is subject to confidentiality?
What is the most precise definition of 'identifiable patient information' that is subject to confidentiality?
A doctor argues their breach of patient confidentiality was justified because it ultimately benefited the patient's health. Under what broader ethical principle might this argument fall?
A doctor argues their breach of patient confidentiality was justified because it ultimately benefited the patient's health. Under what broader ethical principle might this argument fall?
How do privacy rights relate to patient autonomy concerning confidential medical information?
How do privacy rights relate to patient autonomy concerning confidential medical information?
In the UK legal framework, which legislation specifically addresses the regulation of patient information within the health and social care system?
In the UK legal framework, which legislation specifically addresses the regulation of patient information within the health and social care system?
Naomi Campbell's case against MGN (2004) highlights the distinction between privacy and confidentiality. Which statement best describes the central issue regarding this distinction?
Naomi Campbell's case against MGN (2004) highlights the distinction between privacy and confidentiality. Which statement best describes the central issue regarding this distinction?
When is the use of patient data in medical research ethically acceptable?
When is the use of patient data in medical research ethically acceptable?
Why is using interpreters during medical consultations a potentially common breach of confidentiality?
Why is using interpreters during medical consultations a potentially common breach of confidentiality?
In order to prevent accidental breaches of patient confidentiality, which policy would be most important to implement?
In order to prevent accidental breaches of patient confidentiality, which policy would be most important to implement?
Considering the potential risks to patient confidentiality, what is the best course of action for medical professionals when communicating on social media?
Considering the potential risks to patient confidentiality, what is the best course of action for medical professionals when communicating on social media?
What level of accountability do medical students have regarding patient confidentiality?
What level of accountability do medical students have regarding patient confidentiality?
In which of the following situations would breaching patient confidentiality be ethically justifiable?
In which of the following situations would breaching patient confidentiality be ethically justifiable?
In deciding whether to breach confidentiality in the public interest, what should be the primary factor?
In deciding whether to breach confidentiality in the public interest, what should be the primary factor?
Under UK law, in which case is breaching patient confidentiality legally required?
Under UK law, in which case is breaching patient confidentiality legally required?
What is a doctor's obligation if they determine that a patient is medically unfit to drive?
What is a doctor's obligation if they determine that a patient is medically unfit to drive?
What additional factor creates a particularly complex ethical issue when handling a minor who is sexually active?
What additional factor creates a particularly complex ethical issue when handling a minor who is sexually active?
In what specific circumstance involving a child can a doctor justifiably breach patient confidentiality against the child's wishes?
In what specific circumstance involving a child can a doctor justifiably breach patient confidentiality against the child's wishes?
Under what specific condition related to communicable diseases might a doctor be legally obligated to notify a local authority officer?
Under what specific condition related to communicable diseases might a doctor be legally obligated to notify a local authority officer?
What is the most appropriate initial step to take when a doctor receives a request from the police to report details about a patient?
What is the most appropriate initial step to take when a doctor receives a request from the police to report details about a patient?
What is the primary consideration for a doctor when faced with the scenario of a colleague using images of a patient with skin cancer in an international conference presentation?
What is the primary consideration for a doctor when faced with the scenario of a colleague using images of a patient with skin cancer in an international conference presentation?
Under what circumstance is a doctor permitted to disclose information to a patient's sexual partner?
Under what circumstance is a doctor permitted to disclose information to a patient's sexual partner?
According to GMC guidance, how should doctors approach disclosing information about a patient?
According to GMC guidance, how should doctors approach disclosing information about a patient?
What does the Susan Axon Case highlight about confidentiality for minors in the UK?
What does the Susan Axon Case highlight about confidentiality for minors in the UK?
What is true of a doctor's ethical duty of confidentiality after a patient's death?
What is true of a doctor's ethical duty of confidentiality after a patient's death?
Which of the following scenarios best illustrates a consequentialist justification for breaching patient confidentiality?
Which of the following scenarios best illustrates a consequentialist justification for breaching patient confidentiality?
A doctor in a small town inadvertently reveals a patient's diagnosis while chatting with a neighbor at the local grocery store. This scenario best exemplifies which type of confidentiality breach?
A doctor in a small town inadvertently reveals a patient's diagnosis while chatting with a neighbor at the local grocery store. This scenario best exemplifies which type of confidentiality breach?
Which of the following situations falls under 'secondary uses of information'?
Which of the following situations falls under 'secondary uses of information'?
A doctor receives a call from a long-term care facility requesting an update on a patient, Mark, who was admitted to the hospital with dehydration and delirium and is expected to eventually return to the facility. Can the hospital doctor share this information with the long-term facility?
A doctor receives a call from a long-term care facility requesting an update on a patient, Mark, who was admitted to the hospital with dehydration and delirium and is expected to eventually return to the facility. Can the hospital doctor share this information with the long-term facility?
Which of the following is a requirement that must be satisfied to establish a duty of confidentiality?
Which of the following is a requirement that must be satisfied to establish a duty of confidentiality?
Which of the following represents a legally required reason to breach confidentiality under statute law in the UK?
Which of the following represents a legally required reason to breach confidentiality under statute law in the UK?
What should a doctor do if they are one of your patients, James has Hepatitis B. James is sexually active and has told you that he never uses barrier contraception because “it is not very romantic”. His partner, Harriet, is also a patient of yours and you know that James has not informed Harriet about his Hepatitis. Should you disclose the information?
What should a doctor do if they are one of your patients, James has Hepatitis B. James is sexually active and has told you that he never uses barrier contraception because “it is not very romantic”. His partner, Harriet, is also a patient of yours and you know that James has not informed Harriet about his Hepatitis. Should you disclose the information?
What is most important to consider when thinking about patient confidentially and children?
What is most important to consider when thinking about patient confidentially and children?
What are the conditions that establish a Duty of confidentiality
What are the conditions that establish a Duty of confidentiality
What is the main idea about confidentiality and death?
What is the main idea about confidentiality and death?
What is true of consequentialist justifications?
What is true of consequentialist justifications?
What would you consider as a common breach of of confidentiality?
What would you consider as a common breach of of confidentiality?
Based on secondary uses of information, which action is acceptable?
Based on secondary uses of information, which action is acceptable?
A doctor discloses confidential patient information without explicit consent, believing it is in the patient's best interest due to their impaired cognitive function. Under which broader justification might this fall?
A doctor discloses confidential patient information without explicit consent, believing it is in the patient's best interest due to their impaired cognitive function. Under which broader justification might this fall?
In the UK, which of the following legal frameworks provides a patient the right to respect for private and family life, impacting how confidentiality is handled?
In the UK, which of the following legal frameworks provides a patient the right to respect for private and family life, impacting how confidentiality is handled?
Why is anonymization crucial when using patient data for medical research?
Why is anonymization crucial when using patient data for medical research?
Which practice poses a risk of inadvertently breaching patient confidentiality in a hospital setting?
Which practice poses a risk of inadvertently breaching patient confidentiality in a hospital setting?
How does the principle of minimizing disclosure relate to handling patient information?
How does the principle of minimizing disclosure relate to handling patient information?
Under what specific condition is a doctor permitted to disclose information to a patient's sexual partner without the patient's consent?
Under what specific condition is a doctor permitted to disclose information to a patient's sexual partner without the patient's consent?
If a patient has died, what is true of a doctor's confidentiality?
If a patient has died, what is true of a doctor's confidentiality?
What is one of the elements required to establish a duty of confidentiality?
What is one of the elements required to establish a duty of confidentiality?
A doctor receives a request from the police for patient details unrelated to a traffic accident, serious crime, kidnapping or terrorist act. What should the doctor do?
A doctor receives a request from the police for patient details unrelated to a traffic accident, serious crime, kidnapping or terrorist act. What should the doctor do?
What is it important to consider about children and confidentiality?
What is it important to consider about children and confidentiality?
Flashcards
Moral duty of confidentiality
Moral duty of confidentiality
Trust in the doctor-patient relationship relies on keeping patient information private.
Legal duty of confidentiality
Legal duty of confidentiality
It is a legal requirement to protect patient information obtained during a medical consultation.
Identifiable patient information
Identifiable patient information
Any information that could identify a patient, whether written, electronic, or remembered, is confidential.
Ethical basis of confidentiality
Ethical basis of confidentiality
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Doctor's duty
Doctor's duty
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Legal Framework
Legal Framework
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Secondary uses of information
Secondary uses of information
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Accidental breach of confidentiality
Accidental breach of confidentiality
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Medical students and confidentiality
Medical students and confidentiality
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Limits to confidentiality
Limits to confidentiality
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Justifications to break confidentiality
Justifications to break confidentiality
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Legal requirements to break confidentiality (UK Statute Law)
Legal requirements to break confidentiality (UK Statute Law)
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Confidentiality in specific cases
Confidentiality in specific cases
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Responsibilities with gunshot or knife wounds
Responsibilities with gunshot or knife wounds
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Confidentiality & Children
Confidentiality & Children
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Sharing STI information.
Sharing STI information.
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Disclosing information about a patient.
Disclosing information about a patient.
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Disclosure of information about Death
Disclosure of information about Death
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Study Notes
Duty of Confidentiality
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Confidentiality is a key aspect of doctor-patient interactions, involving both ethical and legal obligations
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A moral duty dictates that trust in the doctor-patient relationship hinges on confidentiality
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A legal duty exists not to reveal information obtained during medical consultations
Confidential Information
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All identifiable patient information, be it written, computerized, visual, audio-recorded, or simply remembered, falls under the duty of confidentiality
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This includes clinical details like diagnosis and treatment but also pictures and the identity of the patient's doctor
Ethical and Legal Foundations
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Ethical basis rests on autonomy, wherein personal information belongs to the patient, who can decide and authorise who has access to it
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Doctors should be sensitive, trustworthy, and respectful of patient confidences
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Doctors have a duty of virtuois behavior in the medical context
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Legal compliance also matters, as violating confidentiality can lead to legal and professional repercussions
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Confidentiality is a precondition for sharing in the doctor-patient relationship, essential for accurate diagnosis and effective treatment
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Breaching confidentiality constitutes breaking a promise
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Legal duty of confidentiality under law protects doctors that maintain confidentiality
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Legal duty of confidentiality under law protects society or individuals from harm
Legal Regulation of Confidentiality
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Information must inherently be confidential, like personal data from medical consultations
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Sharing information in a clinical setting implies a confidential obligation
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Unauthorised disclosure can lead to consequences for the provider
Legal Framework
- HIPAA in the US (1996)
- GDPR in Europe (2018) controls how personal information is used by organizations, businesses, or the government, while maintaining data security
UK Legalities
- Human Rights Act of 1998 grants the right to respect private and family life, life, and freedom of expression
- Data Protection Act 1998 (amended 2018) and the GDPR (2018) regulate data protection
- Health & Social Care Act 2012 (UK) regulates patient information
Privacy vs. Confidentiality
- Naomi Campbell sued the Daily Mirror (MGN) for publishing about her drug addiction, arguing a breach of privacy, even though she'd made public statements denying drug use
- Protecting patient information is a core value in healthcare
Secondary Uses of Information
- Using data in medical research needs prior consent and anonymization
- Clinical audits are usually under implied consent
- Conference presentations or educational materials need prior consent
Common Breaches of Confidentiality
- Breaches often occur in routine situations, like sharing patient records with nurses and medical students
- Using interpreters when doctors and patients don't share a language can similarly also be a breach
- Disclosing to proxy decision-makers or family in critical care or after a patient's death may also lead to breaches
Accidental Breaches
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Lapses in patient confidentiality are widespread
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These can occur in crowded places like lifts and canteens, or in A&E departments and wards
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Leaving patient notes in open access areas or failing to secure computers, faxes, and printers causes breaches
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The Health Secretary Jeremy Hunt accidentally breached patient confidentiality (2005) after he tweeted a photo from a hospital with confidential details on the board in the background
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Social networking poses risks if users aren't careful about sharing identifying information online and also may be accused of misconduct
Confidentiality & Medical Students
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Medical students must follow the same confidentiality rules as qualified doctors
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Students have access to confidential information and legal responsibilities, including accidental or minor breaches
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Breaching confidentiality is not absolute
Limits to Confidentiality
- The WMA's International Code of Medical Ethics (2006) states information can be disclosed if the patient agrees or if there’s a real threat of harm to self or others
Breaking Confidentiality
- Is justified with patient consent, in the patient’s best interest, or for public safety, if the law requires or a statutory process approves
Legal Requirements UK
- Legal requirements to break confidentiality include notifications of births, termination of pregnancy, fertility treatment, and instances of notable diseases
- Legal requirements to break confidentiality include notifying authorities about poisonings and serious workplace accidents, criminal investigations, and terrorism
Problems: The Impaired Driver
- Involves notifying the DVLA about fitness to drive, disclosing for public safety, and doctors ensuring awareness of medically unfit drivers
Problems: Abused Patient
- Reporting under Child Protection and Safeguarding is important in cases with children
- It is important to Note the intervention limits with adult capacitous patients
Problems: Gunshot or Knife
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Health Professionals should police and consider how patient poses risk of serious harm
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Police need no automatic powers to demand disclosure, exceptions include traffic accidents, serious crimes
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Note the Good practice to ask for written request
Confidentiality & Children
- The same confidentiality duties apply to information about children and young people
- Breaching confidentiality against a child's wishes is permissible if to override for public interest, the best interest of an incompetent child, or if the disclosure is required by the law
Problems: Sexually Active Minor
- Explore abuse vs consented
- Young people have the need to trust the confidentiality of general practice
- Note UK studies are concerned over confidentiality
Adolescents & Confidentiality
- Mrs Axon had a provision over parental rights over abortion
- Over 13-15 can consent
- However: Operation on under 16yrs preferable to get parental consent.
Problems: Communicable Disease
- Public Health (Infectious Diseases) Regulations 1988;Coronarivus Act 2020
- Diseases like TB or COVID-19 must be notified
- AIDS/HIV are not notifiable.
- There must be serious interest as well
James has Hepatitis B
- Note that there must be Consideration of non-disclosure, harms of disclosure, ethics, law
- If you have reason to believe they are at risk of infection and that the patient has not informed them or has refused to do so”,
Professional Guidance Summary
- Duty: GMC Confidentiality = Not absolute, can disclose personal information, if consented to by patient
- The disclosure is of overall benefit of capacity to consent
- D: Disclosure can be justified in public of interest
Disclosure Summary
- Use anonymised information, be satisfied that the patient
- Explicit consent for identified if not local care
- Keep disclosure to relevant only
Confidentiality of Death
- Ethical duty of confidentiality - remains as it was for death
- Includes legally obligated details for the death certificate and for clinical audits
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