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Transcript of confidentiality
Rachel & Gurnoor
What is it?
Why is it Important?
Its role in a health setting
Why/When can it be breached
-Defences to breaches of Confidentiality
-What are the legal and ethical issues in professional responsibility and confidentiality.
-How to protect client confidentiality?
-Case study 1
-Case study 2
Professional responsibility is the area of legal practice that encompasses the duties of attorneys to help act in a professional manner to understand and comply legislative obligations, obey the law, avoid conflicts of interest, and put the interests of clients ahead of their own interests (Professional Responsibilty, 2009).
The word Confidentiality derives from the Latin word "con"- meaning completeness and "fidere"- meaning trust.Confide is to trust wholly or to impart knowledge with reliance upon secrecy.
Refers to ones ownership of ones body or information about oneself.
What is Confidentiality?
Refers specifically to restrictions upon private information revealed in confidence, where information shared will be disclosed to others.
Why is Confidentiality Important ?
-Builds trust with clients.
-Protect you and the client.
-Autonomy of client to not have sensitive issues announced.
-The independence, truth and opportunity to argue.
The Role of confidentiality
in a health setting
Treatment given to client
Emotional state of the client (behaviours)
Or that the client is a patient.
NOTE: under the privacy legislation in NSW and Victoria deceased clients information is protected up until 30years after death, while the Australian Capitol Territory protects deceased clients confidentiality indefinitely.
Difficulties on Confidentiality in a Health Setting
Multidisciplinary team/ team orientated.
Technology (medical records).
Lack of documentation.
Maintaining confidentiality when speaking to others (other health professionals, family, etc.
50% of health professionals discuss cases to spouses.
70% of cases are discussed at parties. (Weiss, 1982)
Confidences between healt-care providers and patients may be legally protected by three ways:
-Specific Statutory provisions;
According Deontology theory;
a principle that personal information about others, particularly patients, should not be revealed to anyone not authorized to receive such information.
Case Study 1
Case Study 2
The case finding was ‘gross carelessness and improper conduct’ from the ADF doctor.
The doctor had referred senior officer (client) to a psychiatrist without consent from the client
The referral was falsely written as their were no present symptoms.
The ADF doctor notified Commanding Officer (CO) of the clients mental condition as the belief of harm to others may be present (Nisselle, 2005).
For & Against
Inaccurate reports were written about the client
Referred client to psychiatrist without consent from client.
Discussed clients condition to Commanding Officer.
Improperly referred client as symptoms were not displayed
Duty of care to the public.
ADF policy for doctors is to breach confidentiality if concern of harm to others may be present
Defences to breaches of Confidentiality
Express or implied consent of patient.
Duty to protect the public.
Mandatory disclosure under compulsion of law.
Providing information to relatives.
Providing information to other health professionals.
Quality assurance, management and training.
An inappropriate misconduct of the health professionals.
The husband (naturopath) & wife (Acupuncturist) both shared information about their clients inperson.
The client was disclosed with the information she didn't expect anyone to know.
Upset client (mother) was astounsed and outraged.
Both the sisters terminated their respective therapies.
For & Against
- this theory is based on the consequences of the action.
- when confedentiality is breached consequences do occur. one must outweigh them to come to determine the breach should or should be made.
-In case study 2, the breach had to many consequences on the client compared with the community.
- awomen & fiance saw a GP in regards to sexual transmitted disease status as husband was from africa which has a high prevalance rate in HIV.
- the women did not want to proceed with sexual intercourse until status was made clear.
-GP did not seek consent at consultation to share each others results with each other.
- when woman rang she was told that she was negative, but her husbands results could not be revealed and that she needed to ask her fiance.
-When the husband rang he was informed that his results came back positive & that he needed to attend a HIV clinic and the referal would be left at the front desk for him to collect.
- The man did not attend the therapy and altered his results to appear negative.
- the woman then commenced a sexual relationship with her fiance and later was found positive to HIV. (at this stage the man had left australia).
-the women sued the doctor as he did not prevent forseeable harm (Nissille, 2005).
IS THE DOCTOR AT FAULT?
New South Wales (NSW)
The Privacy and Personal Information Act 1998 covers public sector organisations
While The Health Records and Information Privacy Act (HRIPA) 2002 covers information for both the public and private organisations.
The Health Records Act 2001 covers informations from the basic to the maximum with a greater Heakth focus.
Australian Capital Territory
The Health Records Act (Privacy and Access) 1997, it gives access to individuals to their own health records in both private and public sectors (Kerridge, 2009).
How to protect client confidentiality?
Collection of information
Security of information
Accuracy of information
Discloser/use of information
The clients information was exposed to the health professionals spouse.
The client was mentally affected due to her personal information being released.
Patient consent to release confidential or privileged information
(Client Confidendiality cartoon 2- search ID mfln181, 2009)
(Medical History cartoon 10- search ID shrn1330, 2009)
Client confidentiality Cartoon and Comics [Client Confidentiality cartoon 2- search ID mfln181] (2009). Retreived October9, 2012, from http://www.cartoonstock.com/directory/c/client-confidentiality.asp
Hamblin, J (1992). 'Confidentiality, public interest and health professionals duty of care'. Australian Health Review 15:422-34
Kerridge, I., Lowe, M., & Stewart, C. (2009). Confidentiality and record keeping. Ethics and law for the health professions (3rd ed., pp. 219-242). Sydney: The Federation Press.
Nisselle, p. (2005). For debate: Can you tell? Should you tell? ADF Health: Journal of the Australian Defence Health Service. 6(1): 9-11.
Office of the privacy commissioner NSW. (2012). HRIP Act. Retrieved September 27, 2012, from http://www.privacy.nsw.gov.au/lawlink/privacynsw/II_pnsw.nsf/pages/privacy_hripa
Welfare Rights Centre Inc. (2005). Client confidentiality and privacy. Retreived September 25, 2012, from http://wrcqld.org.au/pdf/confidentiality_poilicy.pdf
Cartoonstock [Cartoon Photograph]. Retrieved from http://http://www.google.com.au/imgres?safe=active&hl=en&biw=1920&bih=874&tbm=isch&tbnid=z3oB4GBlsTIezM:&imgrefurl=http://www.cartoonstock.com/directory/m/medical_history.asp&docid=NM5jPStR7dKQcM&imgurl=http://www.cartoonstock.com/newscartoons/cartoonists/shr/lowres/shrn1330l.jpg&w=400&h=301&ei=J61tUojMD6jgyQGi5oHQCQ&zoom=1&iact=hc&vpx=2&vpy=125&dur=2636&hovh=195&hovw=259&tx=119&ty=115&page=1&tbnh=140&tbnw=186&start=0&ndsp=47&ved=1t:429,r:0,s:0,i:77
Greenberg, S. (2006, June 9). Electronic Health Records Debate [Cartoon Photograph]. Retrieved from http://http://psychiatrist-blog.blogspot.com.au/2006/06/hr-4157-electronic-health-records.html
[Cartoon Photograph]. (2010, October 1). Retrieved from http://http://www.google.com.au/imgres?safe=active&hl=en&biw=1920&bih=874&tbm=isch&tbnid=ye0Jbtu7CY8TtM:&imgrefurl=http://blog.timesunion.com/mdtobe/how-do-you-blog-about-patients-while-respecting-their-privacy/203/&docid=Uykg6VD1cyNRFM&imgurl=http://blog.timesunion.com/mdtobe/files/2010/10/confidential
(Welfare Rights Centre Inc., 2005)
Porfessional responsibility is the area of legal practice that encompasses the duties of attorneys to help act in a professional manner to understand and comply legislative obligations, obey the law, avoid conflicts of interest, and put the interests of clients ahead of their own interests (Professional Responsibilty, 2009).