Write Us Case 1 Case 2 Article. Confidentiality is one of the core duties of medical practice. Patients routinely share personal information with health care providers.
If the confidentiality of this information were not protected, trust in the physician-patient relationship would be diminished. Patients would be less likely to share sensitive information, which could negatively impact their care. Why is confidentiality important?
Creating a trusting environment by respecting patient privacy encourages the patient to seek care and to be as honest as possible during the course of a health care visit. See also Physician-Patient Relationship. For conditions that might be stigmatizing, such as reproductive, sexual, public health, and psychiatric health concerns, confidentiality assures that private information will not be disclosed to family or employers without their consent.
Confidentiality: good practice in handling patient information
The obligation of confidentiality prohibits the health care provider from disclosing information about the patient's case to others without permission and encourages the providers and health care systems to take precautions to ensure that only authorized access occurs. Appropriate care often requires that information about patients be discussed among members of a health care team; all team members have authorized access to confidential information about the patients they care for and assume the duty of protecting that information from others who do not have access.
Electronic medical records can pose challenges to confidentiality. While there may be cases where the physician feels naturally inclined to share information, such as responding to an inquiring spouse, the requirements for making an exception to confidentiality may not be met. If there is not explicit permission from the patient to share information with family member, it is generally not ethically justifiable to do so.
Unintended disclosures may occur in a variety of ways. For example, when pressed for time, providers may be tempted to discuss a patient in the elevator or other public place, but maintaining privacy may not be possible in these circumstances. Similarly, extra copies of handouts from teaching conferences that contain identifiable patient information should be removed at the conclusion of the session in order to protect patient privacy. And identifiable patient information should either be encrypted or should not be removed from the security of the health care institution.
The patient's right to privacy is violated when lapses of this kind occur. Personal information of patients shouldn't be disclosed unless necessary. This tool can help you decide if things need to be disclosed. Choose what Dr Peters should do, in our interactive case study, when a patient talks about having a baby with his partner who unknown to him has HIV. Read our case study about a doctor's decision on disclosing information to a parent.
Key legislation factsheet Read our Confidentiality key legislation factsheet in English.
5.1 What is confidentiality?
Daflen ffeithiau deddfwriaeth allweddol Read our Confidentiality key legislation factsheet in Welsh. Consent consultation Have your say on what doctors should consider when discussing treatment and care with their patients. Understanding the new data protection law Read our five top things to know about GDPR and our Confidentiality guidance. Back to main index.
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Sharing information for direct care 26 Implied consent and sharing information for direct care Patient objections to sharing information for their own care If a patient cannot be informed Sharing information with those close to the patient 34 Establishing what the patient wants Abiding by the patient's wishes Listening to those close to the patient Disclosures about patients who lack capacity to consent Considering the disclosure If a patient who lacks capacity asks you not to disclose Rethink research has found that many professionals have insufficient understanding of the law and guidance on confidentiality, and may not have the confidence to share information when it would be sensible to do so.
You may ask for information about a condition from any doctor or psychiatrist.
Confidentiality: Ethical Topic in Medicine
Getting an early agreement with your relative and friend and the treatment team can help avoid later dilemmas over confidentiality. For example, there might be agreement that if the person shows particular early warning signs of becoming ill again, the treatment team can discuss this with the carer so as to reduce the likelihood of further deterioration. It could also be agreed what help the carer might require from the treatment team on an ongoing basis in order to cope better with their relative's illness.
George Schmukler, Dean of the Institute of Psychiatry has provided some useful ways for carers to approach the problem of confidentiality and disclosure with friends and family on the Mental Health Care website.
In this way the person with the mental illness decides what, and at which time, information is shared with specified people. It is best if this is done with the agreement of the treatment team and the people specified. As discussed previously disclosure may be made in the interests of others where a failure to disclose the information may expose the patient, or others, to risk of death or serious harm.
However, as yet there are no guidelines as to what constitutes serious harm.
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A clinician may also have a 'duty of care' towards carers, over and above that to the patient. This means that they may have a duty to inform the carer if the person could be a danger to the family. The National Service Framework for Mental Health sets out standards the Department of Health expects from its mental health services.
What information is confidential?
It states that 'the service user's consent should always be explicitly sought before information about medication, other treatment and care is passed on to their carer' and that 'if the service user is incapacitated, information may be passed to the carer if it is in the service user's best interests'. A breach of confidentiality can be very upsetting. It can weaken the trust between a professional and yourself. If you think that there has been a breach of confidentiality it is important to determine if and why a disclosure was made.
Firstly you should obtain a copy of the guidelines on confidentiality used by the organisation. You may wish to ask the person who breached your confidentiality under what grounds they did this. An advocate should be able to help you do this. If you do not get any satisfactory explanation as to why your confidentiality was breached and you feel that relevant guidelines were not followed then you can make a complaint to the organisation in question. A copy of the complaints procedure should be available from the organisation or a member of staff.
An advocate or the Rethink National Advice Service can help you make a complaint.