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Privacy and Confidentiality (Privasi dan Kerahasiaan)
Privacy and Confidentiality
(Privasi dan Kerahasiaan)
Privacy and Confidentiality (Privasi dan Kerahasiaan) Dr. Amalia Muhaimin, MSc. (Bioethics) Department of Bioethics,

Dr. Amalia Muhaimin, MSc. (Bioethics) Department of Bioethics, School of Medicine Faculty of Medicine and Health Sciences Universitas Jenderal Soedirman

 

Topics

1.

Definitions of privacy and confidentiality .

2.

Reasons for respecting privacy and confidentiality.

3.

Duty of healthcare providers to protect the privacy of patients.

4.

Duty of healthcare providers to maintain confidentiality (aka. professional secrecy ).

5.

Which information should be confidential?

6.

Justified breaches of confidentiality

7.

Special circumstances of research

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Learning Objectives

Mahasiswa mampu menjelaskan definisi serta perbedaan antara privasi (privacy) dan kerahasiaan (confidentiality)

Mahasiswa mampu menjelaskan pentingnya menghargai privasi dan kerahasiaan pasien.

Mahasiswa mampu menjelaskan beberapa pengecualian yang dapat dibenarkan dalam kaitannya dengan kerahasiaan pasien

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Can you give any example related to privacy in everyday life? 1/6/2014 Blok Bioethics and
Can you give any example related
to privacy in everyday life?
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1. Definitions

Privacy (Privasi):

The right to be left alone (hak untuk tidak diganggu)

The right of an individual or a group to be free from intrusion from others, and includes the right to determine which information about them should be disclosed to others

The capacity to be physically alone (solitude); to be free from physical interference, threat or unwanted touching (assault, battery); or to avoid being seen or overheard in particular contexts

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What is confidentiality ?
What is confidentiality ?
How is privacy related to confidentiality?
How is privacy
related to confidentiality?
? How is privacy related to confidentiality? 1 / 6 / 2 0 1 4 Blok

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Blok Bioethics and Health Law 2 Kedokteran Unsoed 9 The new hidden cameras will allow us
Blok Bioethics and Health Law 2 Kedokteran Unsoed 9 The new hidden cameras will allow us

The new hidden cameras will allow us o see if anyone is violating our privacy policy by reading someone else s email

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CONFIDENTIALITY:

 

An attribute of personal information requiring that it not be disclosed to others without sufficient reason

Confidentiality is closely related to privacy, but not identical.

One observes rules of confidentiality out of respect for, and to protect and preserve, the privacy of others

It refers to the obligations of individuals and institutions to use information under their control appropriately once it has been disclosed to them.

 
 

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2. Reasons for respecting privacy and confidentiality

 

a.

Individuals own their information: it is essential to their personal integrity.

b.

For many people privacy is an essential aspect of their dignity; invading their privacy against their will is a violation of their dignity.

c.

Respect for others requires protecting their privacy and the confidentiality of information about them.

d.

Doctors need patients trust!

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Cases:

A few weeks after an Orlando woman had her doctor perform some routine tests, she received a letter from a drug company promoting a treatment for her high cholesterol. (Orlando Sentinel, November 30, 1997).

A 30-year FBI veteran was put on administrative leave when, without his permission, his pharmacy released information about his treatment for depression. (Los Angeles Times, September 1, 1998)

(UC Davis Health System) http://www.ucdmc.ucdavis.edu/compliance/guidance/privacy /example.html

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3. Duty of health care providers to protect the privacy of patients

ask patient s permission to examine him/her unclothed

should ensure that an unclothed patient cannot be viewed by passers-by

etc

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5. Which information should be confidential?

Confidentiality extends to all personal (health) information, including genetic data

UNESCO International Declaration on Human Genetic Data: all medical data, including genetic data and proteomic data, regardless of their apparent information content, should be treated with the same high standards of confidentiality

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6. Justified breaches of confidentiality

a. Sharing information for patient care

In hospital setting access to the patient s chart

Outside hospital family members need patient information to provide care and/or to protect themselves

b. Using interpreters

An interpreter will need access to information about the patient; interpreters should be bound to observe confidentiality

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4. Duty of health care to maintain confidentiality

The duty of maintaining confidentiality ( professional secrecy ) has been part of Western medical ethics since Hippocrates

Preceded the notion that privacy is a right What do you think?

 

Ethics courses in non-Western countries should discuss the source of medical confidentiality in their cultures

 

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When can information be disclosed?
When can information
be disclosed?

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Justified breaches

 

c.

Teaching medical students

Observation & discussion of patients is a necessary part of medical education; students should be informed of their obligation to maintain confidentiality

d.

Mandatory reporting

Health care practitioners should be familiar with the law

Infectious diseases,

 

Suspected child abuse,

Suspected family abuse

Patients should be informed that their information has to be reported to the appropriate authorities

 

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Justified breaches

e. Serious danger to others

patient threaten to harm others, by violence /sexual contact

patient has a transmissible disease such as HIV

f. Genetic information

Do other individuals with the same genetic makeup (close family

members)

have a

right to

a patient s genetic information?

Physicians should consult national regulations/ guidelines

g.

With patient or guardian consent

This should generally be obtained for all breaches of confidentiality and renders the breach acceptable ethically.

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Case studies

Your 36-year-old patient has just tested positive for HIV. He asks that you not inform his wife of the results and claims he is not ready to tell her yet.

A 75-year-old woman shows signs of abuse that appears to be inflicted by her husband. As he is her primary caregiver, she feels dependent on him and pleads with you not to say anything to him about it. How is this case different from Case 1? How would you handle this situation?

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Reference

UNESCO. Bioethics Core Curriculum. Section 1:

Syllabus. UNESCO 2008. Available at:

http://unesdoc.unesco.org/images/0016/001

636/163613e.pdf

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7. Special circumstances of research

a.

Disclosure of personal health information requires prior consent of the research subject;

b.

Anonymized information consent for disclosure? refer to national regulations/guidelines, otherwise international guidelines such as the Declaration of Helsinki

c.

Communities and individuals have a right to privacy information should be kept confidential, especially when disclosure may be harmful to the community.

d.

Scientific publication should respect confidentiality to the greatest extent possible consent is always required when an research subject can be identified in a publication

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