Confidentiality & Consent

1. Confidentiality & Consent Pre-Screening And Study Feasibility

2. Confidentiality & Consent Ethical Imperative ‘…whatever, in connection with my professional practice I see or hear in the life of men, which ought not to be spoken of abroad, I will not divulge…’

3. Confidentiality & Consent Regulation of Confidentiality • Professional Regulation • Common Law • Data Protection Act 1998 • Human Rights Act 1998 • Caldicott Report implemented 1998 • Health & Social Care Act 2000, s.60

4. Confidentiality & Consent Professional Regulation ‘you must treat information about patients as confidential. If in exceptional circumstances there are good reasons why you should pass on information without a patient’s consent, or against a patient’s wishes, you must follow guidance….and be prepared to justify your decision to the patient…the GMC and the courts’

5. Confidentiality & Consent Common Law ‘The law has long recognised that an obligation of confidence can arise out of particular relationships. Examples are the relationships of doctor and patient, priest and penitent, solicitor and client, banker and customer.’ A-G v Guardian Newspapers (No. 2) [1988] 3 All ER 545, per Lord Keith

6. Confidentiality & Consent Common Law ‘…although the basis of the law’s protection of confidence is that there is a public interest that confidences should be preserved and protected by the law, nevertheless that public interest may be outweighed by some other countervailing public interest which favours disclosure’ A-G v Guardian Newspapers (No. 2) [1988] 3 All ER 545, per Lord Goff

7. Confidentiality & Consent Data Protection Act 1998 Information must be: • Processed fairly and lawfully • Obtained for specified purposes and processed accordingly • Adequate, relevant, not excessive • Accurate and up to date • Kept no longer than necessary • Processed in accordance with subjects rights • Protected by appropriate security • Not transferred without adequate protection

8. Confidentiality & Consent Human Rights Act 1998 – Article 8 ‘Everyone has the right to respect for his private and family life, his home and his correspondence. There shall be no interference by a public authority with the exercise of this right except such as in accordance with the law and is necessary in a democratic society’

9. Confidentiality & Consent Caldicott Report – Identifiable Information General Principles • Justify the purpose • Only use when absolutely necessary • Use minimum required • Strictly ‘need to know’ • Understand individual responsibility

10. Confidentiality & Consent Health & Social Care Act 2000 • s. 60 – Public Good v Individual Privacy (utilitarian measure – greatest good for the greatest number) • PIAG – Patient Information Advisory Group

11. Confidentiality & Consent Disclosure is permissible when? • The Patient Consents • Required by Law • In the Public Interest

12. Confidentiality & Consent The Patient’s Consent is the Paramount Practical Issue