MEDICAL SECRECY The confidentiality By Al-Jayyashee M

MEDICAL SECRECY (The confidentiality) By : Al-Jayyashee M.

WHAT IS THE CONFIDENTIALITY? • 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.

• • It covers: Any clinical information about an individual’s diagnosis or treatment A picture, photograph, video, audiotape or other images of the patient Who the patient’s doctor is and what clinics patients attend and when Anything else that may be used to identify patients directly or indirectly. *

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Why respect confidentiality? general view that people have a right to control the release of sensitive or personal information about themselves

Why respect confidentiality? • Trust is an important aspect between patients and healthcare professionals. Patients without fear of a breech of confidentiality should be able to communicate symptoms that often they may feel are embarrassing, stigmatising, or indeed trivial

Why respect confidentiality? • Without this trusting relationship patients may not gives information which may make treating them impossible • Patients may not seek medical attention at all • Has important role in a professional patient relationship establishing a sense of security, freedom of action and self respect for patients

Confidentiality in Law • • • Constitution Universal Declaration on Human Rights 1948 European Convention on Human Rights 1950, 2003 Council of Europe Convention on Data Protection 1981 Convention on Human Rights & Biomedicine 1997 Data Protection Act 1988 & 2003 Freedom of Information Act 1997 -2003 Convention on Human Rights Act 2003 Common Law Lisbon Treaty

The exceptions to confidentiality There are four circumstances where exceptions may be justified in the absence of permission from the patient: • (1) When ordered by a Judge in a Court of Law • (2) When necessary to protect the interests of the patient. • (3) When necessary to protect the welfare of society. • (4) When necessary to safeguard the welfare of another individual or patient.

Breeching Confidentiality • If the individual consents • If required by statute ▫ Infectious disease ▫ Child protection ▫ Road traffic law ▫ Eligibility to health services • The Public Interest ▫ Preventing harm to others ▫ Exposing, detecting or preventing crime ▫ In litigation ▫ Traditionally, no medical research exception has been recognised • Is disclosure for relevant and sufficient reason and proportionate? • A healthcare professional MUST be able to justify any breech of confidentiality

Who has a right to know your healthcare information? • If you are >18 • The competent to understand your medical information in order to make a decision • Only you and the people you authorise to share your private information (adult relatives).

Rules – to keep you safe Keep discussions of patients and families professional Discuss patient information in pre and post clinical conferences – behind closed doors Do not remove medical records from patient care areas Do not make copies of patient’s medical records Do not discuss patients in the elevators, cafeteria, or home

Summary • Confidentiality is VITAL in healthcare – But is not always an absolute right • There are 4 exceptions. • A healthcare professional MUST be able to stand over any breech of confidentiality. • A healthcare professional MUST be inform authorities in certain cases (Child abuse, elderly abuse, public interest) – where danger exists, should only be done after careful consideration • All competent persons over 18 have the right to confidentiality- for all other persons healthcare providers must act in the patients best interests

Case 1 Your patient Harold requests an HIV test. The result is positive. H indicates that it is very important to him that you tell no one he is HIV-positive. He intends to keep this secret. You are aware that H is involved, probably sexually, with a doctor you went to medical school with. You are very strongly inclined to warn your colleague and tell this to H. He insists that you tell no one and threatens you with legal action should you do so. What should you do?

Case 2 Ms. V is 29 years old and has epilepsy. Her driver's licence was revoked when the department of transportation was notified of her recent history of seizures. Ms. V mentions to her physician that she sometimes drives short distances to get groceries with her 3 -year-old daughter in the car. Her physician feels obliged to notify the authorities about this.

Case 3 John Smith, a 45 yr old stockbroker, has been seeing you twice/week for 2 months since a 3 week hospitalization for depression. Had attempted suicide by overdosing on asprin Had not been sleeping for more than 5 hours/night & lost 25 lbs in 6 weeks Now on an antidepressant but still only sleeping 5 hours/night, feeling tired and helpless, cannot concentrate or work Today, he told you he has decided to kill his wife because she is “the root of all his problems”. He insists that you keep this confidential

Questions? Thank you

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