Confidentiality
Confidentiality is the cornerstone of a successful doctor–patient relationship. Indeed the word “confidence” derives from the Latin con “with” and fidere “to trust”.
The Medical Council is clear that doctors who break a patient’s confidence undermine trust in the medical profession and they will be dealt with very seriously. Patients are entitled to expect that information about them will be held in confidence.
Doctors who break a patient’s confidence undermine trust in the medical profession
Survival tips
- Before breaching confidentiality, always consider obtaining consent.
- Take advice from senior colleagues.
- Remember that confidential information includes the patient’s name.
- Competent children have the same rights to confidentiality as adults.
- Doctors can breach confidentiality only when their duty to society overrides their duty to individual patients and it is deemed to be in the public interest.
- Doctors are required to report to various authorities a range of issues, including notifiable diseases (eg, TB), births, illegal abortions and people suspected of terrorist activity.
- The courts can also require doctors to disclose information, although it would be a good idea to contact MPS if you find yourself presented with a court order.
- High-risk areas where breaches can occur are lifts, canteens, computers, printers, wards, A&E departments, pubs and restaurants.
- Be careful not to leave memory sticks or handover sheets lying around.
Scenario
Dr A is a first year SHO working in accident and emergency. He has just completed his first Saturday night shift; which was very busy. Several of the patients who attended were treated for bruises and lacerations to their hands.
Dr A suspected that most of these injuries had been caused by fighting, although this was not always the history given by the patient. One of his more senior colleagues complained that it is “the same every weekend”.
Dr A is unsure whether he can provide the information requested. He calls his consultant, who advises him that in these circumstances he would be unlikely to be able to justify breaching the confidence of all of the patients concerned
Just as Dr A is due to leave the hospital a Garda comes to A&E enquiring about any men, who may have attended with cuts to the hands. He asks for a list of the names and addresses of any such patients who have been seen during the course of the evening. A young man had broken into an empty property, through a glass window, and stolen some goods. The Garda suspects the man was injured in the process. There were no victims; and no suggestion of a threat to public safety, it was a simple case of burglary.
Dr A is unsure whether he can provide the information requested. He calls his consultant, who advises him that in these circumstances, where there has been a blanket request for information and where there is no obvious risk to the general public, he would be unlikely to be able to justify breaching the confidence of all of the patients concerned even if one of them might be the burglar. The consultant agrees that this is a matter for him to deal with and speaks to the Garda personally.