Andrew wrote:
Subject: RE: Help gp-uk
From: "Andrew Herd" <[log in to unmask]>
> It's interesting, this one, isn't it? Philosophically, at what point is
> confidentiality breached?
Good question! As a patient (sometimes) and as a layman
(always) I would guess that a good answer might be 'Confidentiality
is breached when the patient says it is' After all, it is the patient's
confidentiality that is being breached (I think!). Of course, one
would then have to put on caveats, about being able to
demonstrate that there was indeed an actual disclosure of
information, what a lawyer might classify as the 'acta'.
> Presumably discussing a case with one's partners
> is OK, and discussing it with a consultant to whom one might refer is fine,
> but is it OK to discuss an *identified* case with one's spouse, eve if
> he/she is medical, given that he/she could never have the oportunity to
> treat the patient? Extending this, is it OK to discuss *identified* cases
> with other doctors?
I think the patient's (ie mine, when acting in the role of a patient) is
not whether I might or might not be treated, but whether details
about me that I wanted to remain confidential might either be
directly revealed, or be inferred. Looked at from the other end, if
the Practitioner who is treating me wishes to take advice from
another Practitioner, then I would much rather my identity be fully
revealed, so that the second Practitioner is as fully aware as
possible of the details of my case.
>
> One could say that the patient might ultimately benefit because one of the
> other docs might suggest a diagnosis/solution,
In general I have enough confidence in all you nice medicals out
there to believe that you would only enter into such discussions
where you felt the patient would benefit. The exception to this of
course, are those cases which occasionally get reported (with
suitable anonymity for the patient) which are hilariously funny.
> but in the end is the correct
> model the one used in post-grad meetings/medical textbooks, where cases have
> to be anonymised? I remember some time ago there was a hell of a stink
> because photo of a patient was recognisable in a journal.
>
There seems to be a lot to be said for that, as a basic guideline.
Mike Wells
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