Confidentiality in Healthcare. Ethics & Law Sean McArt BSc, MSc, H Dip. ‘The things that most people want to know about are usually none of their business’ George B. Shaw. Session Objectives. What is confidentiality? /Why respect confidentiality? The law
Ethics & Law
Sean McArt BSc, MSc, H Dip.
‘The things that most people want to know about are usually none of their business’ George B. Shaw
All identifiable patient information, whether written, computerised, visual or audio recorded or simply held in the memory of health professionals, is subject to the duty of confidentiality.
Broadly speaking the courts have recognised three elements to deciding whether a matter is confidential:
‘Information regarding a patient’s history, treatment and state of health is privileged and confidential...’
‘Professional judgement and responsibility should be exercised in the sharing of such information with professional colleagues. The confidentiality of patient’s records must be safeguarded.’
The Data Protection Commissioner
Where a person suffers damage as a result of a failure by a data controller or data processor to meet their data protection obligations, then the data controller or data processor may be subject to civil sanctions by the person affected. Ordinarily, the "injury" suffered by a data subject will be damage to his or her reputation, possible financial loss and mental distress.
‘State to protect & vindicate the citizen’s right to constitutional privacy’
‘Protection of personal data, not least medical data, is a fundamental importance to a person’s enjoyment of his or her right to respect for private and family life ... Respecting the confidentiality of health data is a vital principle in the legal systems of all the contracting parties to the convention’
Gives individuals legal rights to:
There are four circumstances where exceptions may be justified in the absence of permission from the patient:
Tarasoff v. Regents of the University of California
Dr. Gold in turn referred him as an out-patient to a staff psychologist named Dr. Moore. Following several sessions Poddar outlined his intention to kill Tatiana, on her return from vacation
Hunter v. Mann  QB 767
Re C (adult refusal of medical treatment)  1 All ER 819
General Medical Council. Confidentiality: protecting and providing information. http://www.gmc-uk.org/guidance/current/library/confidentiality.asp
‘Insofar as practicable, give due consideration, having regard to his age and understanding, to the wishes of the child’. (Child Care Act 1991)
Law Reform Commission in Ireland have suggested that it is the prevailing belief in Irish legal opinion that under 16’s have no personal power to consent to medical treatment
‘Against all the odds, and despite being referred to a hospice, Collette showed signs of recovering from bowel cancer. After several months, the consultant decided that Collette was no longer terminally ill, although he could not be certain that she would not become ill again in the future. Accordingly, he felt she no longer required the extensive support supplied by the hospice and discharged her. Collette was very upset by this, partly because she did not want to loose her terminally ill status, which had generated her more attention from her family than she had become accustomed to in the past.
The hospice staff were not unsympathetic. They had promised that they would not abandon her and would care for her until she died. The staff also widely believed that her family had rather neglected her previously. Because they did not wish to let Collette down, she was given radically reduced honorary status as an out-patient. For instance she still attended social events and had her hair set by the hair dresser who donated some of her spare time to the hospice. It quickly became obvious that Collette’s family did not realise that she was no longer thought to be terminally ill. The nurse manager attempted to talk to Collette about this, but she was politely and firmly told to mind her own business.’
(Katherine C. Chretien, et al. JAMA. 2009;302(12):1309-1315 Oct, 2009)