Confidentiality - the basics

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 GMC is clear that doctors who break a patient’s confidence undermine trust in the medical profession and they will be dealt with very seriously.

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 working in the minor injuries unit, where he sees a variety of patients. One of them is a young man who attends with several cuts on his hands. The man claims that he was washing a glass at home and accidentally shattered it, injuring himself. Dr A believes that the pattern of cuts is unlikely to be caused by that mechanism of injury, but the patient sticks to his story.

Later that day, a police officer comes to A&E enquiring about any men, who may have attended with cuts to the hands. A young man had broken into an empty property, through a glass window, and stolen some goods. The police officer suspects the man was injured in the process. There were no victims; and no suggestion of threat to public safety, it was a case of burglary.

Dr A is unsure whether he can mention anything about his earlier patient. He talks to his consultant, who advises him not to mention this to the police, as he owes a duty of confidentiality to the patient. The consultant points out that there is no obvious risk to the general public, even if his patient was really the burglar.