Five facts about patient confidentiality
BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j636 (Published 08 February 2017) Cite this as: BMJ 2017;356:j636
Abstract
The General Medical Council has revised and expanded its guidance on confidentiality for all doctors practising in the UK. Here are five facts from the guidance,1 which comes into effect on Tuesday 25 April
Confidentiality is not absolute
Confidentiality is an important ethical and legal duty for doctors, but it is not absolute. Doctors may disclose personal information without breaching duties of confidentiality under certain circumstances, such as when the disclosure is of overall benefit to a patient who lacks capacity to consent.
Explicit or implied
A patient’s consent to disclose information may be explicit or implied. Explicit consent is given when a patient actively agrees to the use or disclosure of information. Implied consent refers to circumstances in which it would be reasonable to infer that the patient agrees to the use of the information, even though this has not been directly expressed.
Capacity
Doctors must work on the presumption that every adult patient has the capacity to make decisions about the disclosure of his or her personal information. Doctors must assess patients’ capacity to make a decision at the time that it needs to be made, recognising that fluctuations in patients’ illnesses may affect their ability to understand, retain, or weigh up information or to communicate their wishes.
Disclosures required by statute
A doctor must disclose information if it is required by statute or if the doctor is ordered to do so by a judge or presiding officer of a court. If this is the case, the doctor must be satisfied that the disclosure is legally required and should disclose only information that is relevant to the request. Where possible, doctors should tell patients about such disclosures, unless that would undermine the purpose.
Disclosure required by law
Many laws require disclosure of patients’ information for purposes as diverse as the notification of infectious diseases, the provision of health and social care services, the prevention of terrorism, and the investigation of road collisions.