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The public needs to be honestly informed as to the limits of
confidentiality and privacy in the NHS.
Despite guidance from DoH., GMC., the Information Commissioner, backed by
Achew and many other organisations, it is still the exception to see any
notices or leaflets in NHS premises advising people of the fact that
despite much is made of the 'confidential doctor-patient relationship' -
it does not and cannot realistically exist in the NHS. Just as doctors are
properly informed due to their privileged access to information, so the
public has an equal right to know the truth so that they may make informed
decisions as what services they access, to whom they choose to disclose
personal information. Doctors themselves rarely disclose personal
information in the NHS. e.g. They have a special counselling service so
that their privacy is doubly safeguarded, (even so many do not risk the
potential for breach of privacy there either).They are not asking people
to state their wishes to put on file ,so disengenuously excluding a wider
debate with people who consult them.
One dilemma is that even if properly informed, some may not have the
means to choose other than NHS services. They can be used against their
wishes for research, so building on the historical power differential
which some parts of the medical world are attempting to address with
concepts of partnership, treating others with equality and dignity - where
this is missing people become simply research fodder. The vast majority
of us, including doctors who are also members of the public, are
altruistic and wish to partipate in research - but only if treated like
human beings not research objects.