Ferguson AH. Medical confidentiality. In: Carrick D, Gross M, ed. Military medical ethics for the 21st century. London: Ashgate Publishing; 2013. The guide contains a section on information management and protection. This includes helpful tips on physicians` personal responsibility to protect patient information. There are also tips on when to share information after a patient dies. It is in the nature of things that medical practice implies opening privacy to external control. Understanding that medical consultations are confidential promotes openness, trust and open disclosure of any potentially relevant information between patient and physician.
This, in turn, enables effective and efficient diagnosis, prognosis and treatment of diseases and diseases. Confidentiality is therefore an integral part of the patient-physician relationship and plays a crucial role in the profession`s primary goal of healing. As such, it can be considered essential to the moral nature of the practice [1]. MDU Advice You should assess whether failure to disclose this information “may expose others to a risk of death or serious harm” (paragraph 64 of GMC`s Privacy Guide). An admission of a serious crime such as child abuse is an example of when disclosure is likely to be appropriate. The GMC does not define serious crime in its guidelines, but refers to examples in the NHS Code of Conduct for Privacy. These include murder, manslaughter, rape, abduction, and child abuse or neglect that causes significant harm. Angus H. Ferguson, MPhil, PhD is based at the University of Glasgow in Scotland. His research in the history of medicine includes interdisciplinary work on medical ethics, infant nutrition, and sudden infant death syndrome. He is completing a book examining the changing frontiers of medical secrecy in modern Britain and will be published in the Medical Law and Ethics in Ashgate series. There is not a single law that regulates the law of confidentiality, but it has evolved through case law and is supported by various laws.
You must have the patient`s consent or determine that disclosure without consent is in the public interest. The police may be able to obtain a court order, which would then mean that you would have to disclose the specific information mentioned in the order without the patient`s consent. The GMC states that you may not disclose personal data to third parties without the express consent of the patient, unless this is of general benefit to a patient who is unable to give consent, required by law, ordered by a court or justified in the public interest. If disclosure is not permitted under the common law, the patient or client could sue not only the organization, but also the person responsible for the violation. According to the British Medical Association (BMA), any identifiable information about a patient stored by a healthcare professional in any form is confidential. This information includes, for example, clinical information, images of the patient, who the patient`s doctor is, which clinics the patient visits and when, and anything that can be used to directly or indirectly identify a patient. 10 A physician shall disclose information if required to do so by law or if a judge or presiding judge of a court so requests. If this is the case, the physician must be satisfied that disclosure is required by law and must disclose only the information relevant to the request. If possible, physicians should inform patients of these disclosures, unless doing so would compromise the purpose. There are also laws if the patient`s mental performance has recently deteriorated, such as . B the permanent power of attorney.
If the patient whose information is to be disclosed is a child who does not have legal capacity, the personal data may be disclosed to parents or authorities if it is in the best interests of the child. There is also an overriding public interest in disclosure where the child is at risk of abuse, as disclosure would prevent serious crimes or in other cases where the child`s own conduct would present a risk of serious harm. The Privacy Code of Conduct is the result of extensive public consultation involving patients, customers, caregivers and citizens, the DoH, other health care and social service providers, professional associations and regulatory bodies. The officer explained that they urgently needed information to identify the driver. The family doctor recognized the driver as a patient and wondered if she should tell the police her name and address. Confidentiality is an important ethical and legal obligation for physicians, but it is not absolute. Physicians may disclose personal information in certain circumstances without breaching confidentiality obligations. B, for example, if disclosure is of general benefit to a patient who is unable to consent. During the nineteenth and early twentieth centuries, an era of international industrial and military competition, there was a shift from the relatively unbridled freedom of the individual in the private medical market to a stronger emphasis on the collective. As a result, some physicians have been drawn between competing obligations of patient confidentiality and collective well-being.
While the common law continued to reject requests for medical privileges, legal and health policy requirements placed a new emphasis on the value of medical information beyond its original function in the patient-physician relationship. In the UK, this emphasis reflected the state`s growing interest in population health as a key resource for the country`s economic and military competitiveness [7]. This includes the use of anonymized information where possible and serves the purpose; explain to the patient how the information will be used; and limit disclosure to the minimum necessary. Pellegrino Hrsg. The moral foundations of the patient-doctor relationship: the essence of medical ethics. In: Lounsbury DE, Bellamy RF, ed. Military medical ethics. Office of the United States Surgeon General and Department of the Army; 2003:3-21. www.bordeninstitute.army.mil/published_volumes/ethicsVol1/ethicsVol1.html. Retrieved 9 August 2012. In Hunter v. Mann, it was said: 3`.
the physician is required not to disclose [voluntarily] any information obtained as a physician in a professional capacity without the patient`s consent. When considering disclosure in the public interest, the GMC says you need to weigh the impact of disclosure on the patient and trust in physicians in general against the potential benefits that come from sharing information. It is important that you clearly document in the patient`s record your reasons for disclosure, the information you are disclosing, the steps you have taken to obtain the patient`s consent, or the reasons why you have not done so. In certain circumstances, the law allows the police to obtain information from anyone, including doctors, which can lead to the identification of a driver who has allegedly committed a traffic violation. It is important to note that failure to comply with such a police requirement is a criminal offence. The common law duty of confidentiality presumably applies to the records of deceased patients under the Information Tribunal`s appeal number: EA/2006/0010 of 17 September 2007 between Pauline Bluck, the Information Officer and epsom & St Helier University NHS Trust and Lewis v Secretary of State for Health [2008] EWHC 2196. A mentally capable patient who is at risk of serious harm and refuses to disclose information must be warned of the risks, but the patient`s decision must be respected.37 However, information may be shared without the patient`s consent if others suffer serious harm as a result.38 You may do so anonymously, without disclosing the identity of the patient. If you choose to disclose information to the police, you must limit the information you provide to the minimum necessary for that purpose and provide only relevant information. Because of its legal basis, attitudes towards medical privilege may vary from one regional jurisdiction to another – as well as between civil and criminal law of the same jurisdiction. Although the courts have recognized the importance of confidentiality for effective medical practice, with a few exceptions, they have consistently held that the objectives of justice replace the duty of professional secrecy of physicians [6]. In most criminal justice systems, the judicial rejection of professional secrecy has been an area in which exceptions to the rule of confidentiality have emerged. However, there are cases where confidentiality can and should be broken.
To inform medical staff of what these cases are, the GMC (General Medical Council) has compiled specific guidelines for privacy and when it can be broken in the health field. .
