Confidentiality-Common Ethical Scenarios

Updated: May 7, 2020

By Usman Nasir


Before this article, check out the previous one called “Everything about ethics at interviews” to read about how to approach ethical scenarios and questions.


What is confidentiality?


· A healthcare professional should keep any information (medical or personal) about their patient confidential. This includes any identifiable patient information, such as clinical diagnoses or personal information (address, date of birth etc.)

· It is the professional duty, as a medical student and a doctor, to promote confidentiality.


Some ethical arguments to start you off


Maintaining confidentiality builds trust in a doctor-patient relationship:

o Allows patients to feel more comfortable opening up about their concerns.

o Stops patients under reporting, withholding information or even hiding anything.

· When can confidentiality be breached? (this is not an exhaustive list)

o If breaking confidentiality is vital for the safety of that patient e.g. if they lack capacity and are at risk of harm or if they are suffering from neglect or abuse.

o Disclosing information in the best interests of society might outweigh the need to keep that information confidential in certain situations:

§ For a legal investigation.

§ To prevent a crime.

§ To prevent terrorism.

§ Stop the spread of infectious diseases.

· ALWAYS remember that it should always be documented when confidentiality is about to be broken. You should tell your patient that you are about to break confidentiality (if appropriate).


Question bank


· What does the term “patient confidentiality” mean to you?

· Give an example in your work experience/volunteering where you have seen patient confidentiality in action.

· Why is confidentiality important in a doctor-patient relationship?

· Give examples of when is it appropriate to breach confidentiality? Are there any situations where confidentiality must be breached?

· What are some of the GMC guidelines regarding confidentiality?

· How might you promote confidentiality in clinical placements as a medical student.


Scrubbed up Tips


· Make sure you have a solid understanding of the term “patient confidentiality”.

· Read GMC tomorrow’s doctors and briefly be aware about what it says about confidentiality.

· BMA ethics toolkit for medical students is a great place to understand what confidentiality means. It gives patient examples as well, to help you out.

· Reflect upon your situations in your work experience or volunteering, where you have seen confidentiality in action.

· Have a solid understanding of when confidentiality can be breached.

· Use the 4 ethical pillars throughout your answer.


References

Definition of confidentiality and why it is important.

https://www.bma.org.uk/advice-and-support/ethics/medical-students/ethics-toolkit-for-medical-students/confidentiality BMA ethics toolkit for medical students

When can confidentiality be breached?

https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/confidentiality/disclosures-for-the-protection-of-patients-and-others GMC Confidentiality: good practice in handling information. Disclosures for the protection of patients and others.

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