Documente Academic
Documente Profesional
Documente Cultură
Session Objectives
What is confidentiality? /Why respect
confidentiality?
The law
Is confidentiality absolute/Exceptions to
confidentiality/Breeching confidentiality
Confidentiality Death, incapacity and minors
Confidentiality - Palliative care case study
Confidentiality
Generally, if
institution/person A holds
information about person B
then person C cannot obtain
that information in the
normal course of events
without the consent of person
B
http://www.dataprotection.ie/viewdoc.asp?DocID=225 (2003)
http://www.nursingboard.ie/en/publications_current.as
px?page=4
)
Confidentiality in Law
Constitution
Universal Declaration on Human Rights 1948
European Convention on Human Rights 1950, 2003
Council of Europe Convention on Data Protection
1981
Convention on Human Rights & Biomedicine 1997
Data Protection Act 1988 & 2003
Freedom of Information Act 1997-2003
Convention on Human Rights Act 2003
Common Law
Lisbon Treaty
Constitution
Article 40.3.1 protects the personal rights of
each citizen
These personal rights include implied rights
Implied right to privacy first outlined in McGee
v. Attorney-General [1974] I.R.284
State to protect & vindicate the citizens right to
constitutional privacy
California
Prosenjit Poddar a university student from India
studying in the U.S. attended folk dancing classes
with Tatiana Tarasoff and subsequently kissed her
on New years eve.
Tatiana rebuffed his advances sending him into an
emotional crisis, in which he became depressed neglecting his appearance, studies and health
Owing to this he was placed under the care of a
psychiatrist Dr. Gold
Breeching Confidentiality
If the individual consents
If required by statute
Infectious disease
Child protection
Road traffic law
Eligibility to health services
Groups
Incapacity
Death
Minor
Incapacity
Where an individual cannot;
comprehend or retain treatment
information, believe it and
weigh it in the balance to arrive
at a choice then they are
considered unable to consent to
that treatment
Death
Declaration of Geneva
respect for the secrets
confided... even after the
patient has died
General Medical Council
extends after death
Morally an individuals
confidentiality is still
considered to require respect
Minors
Unwanted parental intrusion to confidentiality
can result in minors loosing trust in healthcare
providers and move away from health care
Gillick competency has not been shown by any
Irish case law to exist
Minors
For those aged between sixteen and eighteen, the NonFatal Offences Against the Person Act (1997), allows
consent to surgical, medical or dental treatments (this
act does not allow them to decline treatment)
The Child Care Act (1991)
Insofar as practicable, give due consideration, having
regard to his age and understanding, to the wishes of
the child. (Child Care Act 1991)
Law Reform Commission in Ireland have suggested that it
is the prevailing belief in Irish legal opinion that under
16s have no personal power to consent to medical
treatment
Case
Against all the odds, and despite being referred to a hospice, Collette showed
signs of recovering from bowel cancer. After several months, the
consultant decided that Collette was no longer terminally ill, although he
could not be certain that she would not become ill again in the future.
Accordingly, he felt she no longer required the extensive support supplied
by the hospice and discharged her. Collette was very upset by this, partly
because she did not want to loose her terminally ill status, which had
generated her more attention from her family than she had become
accustomed to in the past.
The hospice staff were not unsympathetic. They had promised that they
would not abandon her and would care for her until she died. The staff
also widely believed that her family had rather neglected her previously.
Because they did not wish to let Collette down, she was given radically
reduced honorary status as an out-patient. For instance she still attended
social events and had her hair set by the hair dresser who donated some of
her spare time to the hospice. It quickly became obvious that Collettes
family did not realise that she was no longer thought to be terminally ill.
The nurse manager attempted to talk to Collette about this, but she was
politely and firmly told to mind her own business.
(Webb 2005)
Out-side work
Unsecured laptops
USB keys
Summary
Confidentiality is VITAL in healthcare But is not
always an absolute right
There are 4 exceptions defined by the Irish medical
council
A healthcare professional MUST be able to stand over
any breech of confidentiality and it should be a last
resort
Duties to inform authorities in certain cases (Child
abuse, elderly abuse, public interest) where danger
exists, should only be done after careful consideration
All competent persons over 18 have the right to
confidentiality- for all other persons healthcare
providers must act in the patients best interests
Questions?