BMJ  2008;336:888-891 (19 April), doi:10.1136/bmj.39521.357731.BE

Practice

Competent Novice

Confidentiality

¹ General Adult Psychiatry, Maudsley Hospital, London SE5 8AZ , ² Department of Psychological Medicine, Institute of Psychiatry, King’s College, London SE5 8AF

The first 150 words of the full text of this article appear below.

Confidentiality in the medical setting refers to "the principle of keeping secure and secret from others, information given by or about an individual in the course of a professional relationship,"¹ and it is the right of every patient, even after death.²

Breaches of confidentiality are common, albeit usually accidental.² Around a third of the calls received by the Medical Protection Society from doctors are related to confidentiality, particularly in general practice.³ It is the most common reason for doctors, at any stage of their training, to seek advice from their indemnity unions. Confidentiality lies at the heart of the relationship between doctor and patient, and one survey suggests that the public view any breaches of this as the most important reason for striking doctors off the medical register.⁴

Maintaining confidentiality is part of the "good faith" that exists between doctor and patient.⁵ Ignoring patients’ rights to confidentiality would lose their . . . [Full text of this article]

Key points

What are the challenges?

During conversation
With colleagues
Box 1 Day to day disclosure of confidential information
With relatives
When writing
Computers and data entry
The Data Protection Act
Confidentiality, consent, and children under 16 years

Compulsory disclosure

Protection of the public and third parties
Box 2 NHS code of practice (2003) definitions
Serious crime
Risk of harm
Criminal proceedings and police investigations
Statutory obligations
The courts
Which crimes should be disclosed?
Notifiable diseases
Medical conditions affecting fitness to drive

Audit, research, and publications

Box 3 Audiovisual and photographic records

Conclusion

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