A dual duty to patients and society?

Anything said within a doctor’s surgery should remain confidential between the doctor and patient, following the Data Protection Act. But, can a doctor rightfully disclose a patient’s personal information? And if so, for what reasons?

Proteje la confidencialidad del paciente
Photo by Daquella manera
Doctors actually have a dual responsibility – to their patients and to society. The GMC states that disclosure without consent may be justifiable in exceptional circumstances where it is in the public interest to do so, where it is necessary to protect the patient or others from serious risk of death or serious harm. And, in certain circumstances, disclosure may be required by law.

But what constitutes a serious risk of death or harm? What about a patient who has been involved in public disorder? Should a doctor pass on this person’s information? Just how far should doctors make decisions about how serious a crime has to be before it is reported?

The GMC’s Supplementary Guidance Confidentiality: Reporting Gunshot and Knife Wounds, says:

“Such a situation might arise, for example, when a disclosure would be likely to assist in the prevention, detection or prosecution of serious crime, especially crimes against the person.”

Confidentiality may seem a very straightforward principle, but translating principle into practice can be problematic. There are all sorts of situations where it is difficult to know if patient information should be shared or not – with the police, for example, or Social Services.

MPS Senior Medicolegal Adviser Dr Su Jones says:

“Don’t get caught up in any public frenzy; have a measured, professional response in situations such as large-scale public disorder and rioting. Reflect on whether the disclosure is really in the public interest to avoid a knee-jerk reaction.”

It is important to bear in mind that it is not the medical profession’s responsibility to maintain law and order, as The Independent’s Health Editor Jeremy Laurance says:

“Its duty is to provide care to those who need it, non-judgmentally, without fear or favour.”

If you do decide to disclose a patient’s information, you should take care to document all decisions and discussions that have taken place.

Remember: You must weigh the harm that is likely to arise from non-disclosure of information against the possible harm both to the patient, to others and to the overall trust between doctors and patients, arising from the release of that information.

If you are unsure whether or not to share information, seek advice from an experienced colleague, or call MPS for advice.

 

This is a summary of an article that appeared in MPS Casebook. Read the full article here.

Also read Jeremy Laurance’s article, ‘Medical life: Patients’ trust must not be betrayed in the wake of the riots’ which appeared in The Independent here.

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