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STUDENTS' GOPHER
NOTES ON CONFIDENTIALITY
IN HEALTH CARE
1: Topics / Simple cases
Prof Geoff Hunt, EIHMS, University of Surrey
Here is a list of the main topics that might be covered under the heading 'Confidentiality in Healthcare'
0 Introduction – preliminary cases
1 Philosophy of Confidentiality
Individual space (Cf. privacy of person)
“Specific purpose”, “Need to Know”
Balanced judgement – damage, secrecy, exceptions.
2 Professional ethics
Disciplinary procedure, cases
Sec. 5 of Code of Conduct [for copy click here http://www.nmc-uk.org]
Confidentiality & Good Practice in the ward
Raising public concerns
Inter-agency issues
3 Law
Common Law
Data Protection Act [for official details click here http://www.dataprotection.gov.uk]
Personnel / Contract of Employment
Whistleblowing, Public Interest Disclosure
Freedom of Information
4 Contemporary Social Issues
Genetics
Reproductive Technology
Research
etc.
Confidentiality: Preliminary Cases
[see Handout]
Prof Geoff Hunt 2002
Ordinary Life
Case 1: You are having difficult coping with the breakdown of a relationship. You tell your best friend personal things about your recent partner. You later learn from someone else that these personal things have become known to a number of people who are not friends of yours, and some of these people seem to look down on you. How do you feel about your best friend? If there is something wrong with your friend’s action, how would you describe it?
Professional Life
Case 2: You need a loan to pay for your education. You speak to your bank manager. He asks you many questions about your financial situation in order to make an assessment. He wants to know about existing loans. You tell him that you once tried to start a small business and it failed, so you were declared bankrupt. Later, your next door neighbour, who is an acquaintance of the bank manager, drops hints to you about how difficult it is to get a loan when you have been a bankrupt. You realise that the bank manager has told your neighbour about the conversation in his office. Is something wrong here? How would you describe what the manager has done?
Professional Nursing
Case 3: You are a patient P in a ward. You have been involved in serious traffic accident in which someone died. The ward phone rings and a nurse picks it up. It seems someone is asking for you. You hear her saying “Yes, P from that accident is here ... No, I don’t think you can speak to him …well, he is in quite a serious condition … yes, he has a ruptured spleen and concussion ….Yes, try later … Goodbye.” Is anything wrong here and if so, what? How should she handle such a call?
Case 4: You are a nurse in A&E and it is very busy Saturday night. A patient is admitted within a puncture wound to the abdomen. The patient is bleeding badly and is very upset and angry. He tells you “He stabbed me with a knife .. he was trying to kill me…” Later, a police officer arrives. The place is so busy the officer is not getting much attention. He stops you as you pass by. He asks, “Do you have someone here whose been stabbed?” What do you say?
Case 5: You start attending to patient P, when you see that P’s friend is looking through some of P’s treatment notes while P is dozing. What do you do?