I think that information about patients lie within a range of degrees of
confidentiality in a similar way that capacity to consent (e.g. Gillick
competence) does. Patient confidentiality is not too dissimilar to the
confidentiality of the operations of an organisation, e.g. an NHS Trust.
There are perhaps two categories of confidentiality: (a)
restricted/personal, and (b) general.
Information that might seriously damage an organisation's reputation lay
within a different category to general info such as "the Trust is seriously
overspent". I think that perhaps patient information too could be treated
as (a) that which would forseeably have an adverse affect on the patient if
disclosed to certain individuals, and (b) that which is personal to the
patient but would not forseeably have an adverse effect - such as, "Mr X is
going for a scan now". A judgement still has to be made to whom to disclose
certain types/categories of information.
I think that the GMC guidance is there as a reasonable body of opinion that
if we act within it we are unlikely to fall foul of the law; but the GMC
guidance itself in not law and not perfect. If it were, then perhaps the
recommendations the Shipman and other Inquiries would be meaningless.
We are not robots, and there are a lot of grey areas. However, I too find
the 'competition' between emergency staff to tell a relative what is wrong
quite disturbing - quite often info has been discussed without your
(professional) consent, before you are ready to do so. Is this a potential
disciplinary matter??
Tony Adams
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