Medical Confidentiality and Legal Privilege (Social Ethics and Policy)

Confidentiality: good practice in handling patient information
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Laws and regulations sometimes permit, but do not require, the disclosure of personal information. You must also be satisfied that the other relevant requirements for disclosing information are met see paragraph You must disclose personal information about an adult who may be at risk of serious harm if it is required by law see paragraph Even if there is no legal requirement to do so, you must give information promptly to an appropriate responsible person or authority if you believe a patient who lacks capacity to consent is experiencing, or at risk of, neglect or physical, sexual or emotional abuse, or any other kind of serious harm, unless it is not of overall benefit to the patient to do so.

If you believe it is not of overall benefit to the patient to disclose their personal information and it is not required by law , you should discuss the issues with an experienced colleague. You must be able to justify your decision. As a principle, adults who have capacity are entitled to make decisions in their own interests, even if others consider those decisions to be irrational or unwise. You should usually ask for consent before disclosing personal information about a patient if disclosure is not required by law, and it is practicable to do so. You can find examples of when it might not be practicable to ask for consent in paragraph In other cases, you should ask for explicit consent to disclose personal information unless it is not appropriate or practicable to do so.

If an adult patient who has capacity to make the decision refuses to consent to information being disclosed that you consider necessary for their protection, you should explore their reasons for this. It may be appropriate to encourage the patient to consent to the disclosure and to warn them of the risks of refusing to consent.

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In very exceptional circumstances, disclosure without consent may be justified in the public interest to prevent a serious crime such as murder, manslaughter or serious assault even where no one other than the patient is at risk. This is only likely to be justifiable where there is clear evidence of an imminent risk of serious harm to the individual, and where there are no alternative and less intrusive methods of preventing that harm.

This is an uncertain area of law and, if practicable, you should seek independent legal advice before making such a disclosure without consent. The Department of Health in England has published Information sharing and suicide prevention: consensus statement , which is consistent with the principles in this guidance. Safelives has published guidance on disclosing information to multi-agency risk assessment conferences MARACs , which are local meetings established to discuss how to help individuals who are at high risk of murder or serious harm.

The guidance is available on the Safelives website. Doctors owe a duty of confidentiality to their patients, but they also have a wider duty to protect and promote the health of patients and the public. Some laws require disclosure of patient information for purposes such as the notification of infectious diseases and the prevention of terrorism.

How important is doctor-patient confidentiality to you?

You must disclose information if it is required by law, including by the courts see paragraphs 87 - There are a large number of laws that require disclosure of patient information — for purposes as diverse as the notification of infectious diseases, the provision of health and social care services, the prevention of terrorism and the investigation of road accidents. You can find advice about disclosures that are permitted but not required by law in paragraph The courts, both civil and criminal, have powers to order disclosure of information in various circumstances.

You must disclose information if ordered to do so by a judge or presiding officer of a court.

You should only disclose information that is required by the court. You should also tell the judge or the presiding officer if you think disclosing the information might put someone at risk of harm. If disclosure is ordered, and you do not understand the basis for this, you should ask the court or a legal adviser to explain it to you. You should also tell the patient whose information the court has asked for what information you will disclose in response to the order, unless that is not practicable or would undermine the purpose for which disclosure is sought.

You may disclose information without consent to your own legal adviser to get their advice. If they want further information, either side may apply to the court to take a precognition on oath. If that happens, you will be given advance warning and you should seek legal advice about what you may disclose. You should consider any reasons given for refusal. Confidential medical care is recognised in law as being in the public interest.

The fact that people are encouraged to seek advice and treatment benefits society as a whole as well as the individual. It also has a handy flowchart which you can use to help you decide whether to share the information. The guidance includes a section on managing and protecting information. It also gives advice on when you can share information after a patient has died. This guidance came into effect 25 April We also have six pieces of shorter guidance which explain how to apply the principles of Confidentiality to specific situations doctors often encounter or find hard to deal with.

These are:. We help to protect patients and improve medical education and practice in the UK by setting standards for students and doctors. We support them in achieving and exceeding those standards, and take action when they are not met. Home Ethical guidance Ethical guidance for doctors Confidentiality. Confidentiality is an important legal and ethical duty but it is not absolute. Download the guidance You can download the guidance in English or Welsh.

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Duty of confidentiality

References: [1] [6] [7] [8] [9] [10]. Recently Added. You can find all GMC guidance on professional standards available on our website. McHale examines cases to see whether the denial in law of the doctor-patient privilege is consistent with the protection of other confidential relationships. Add to Wish List.

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