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Legal consideration
Natural human desire due to fear of social embarrassment or disapproval or the fear of discrimination, stigmatization Protects from information misuse against patient Builds confidence and open communication Respects patients privacy, dignity and individuality Demonstrates doctors fidelity to the patient Encourages free exchange of information which is critical for effective medical intervention, public health effort, and preventing harm to others
Breaching Confidentiality
- Medical confidentiality is not absolute - Confidentiality can be breached in exceptional cases and with appropriate justification after patients approval
If you decide to disclose confidential information, you must be prepared to explain and justify your decision.
- Before breaching confidentiality think of: - Patients consent - Benefit of patient - Prevent harm to others - Law - Benefit for others: medical research
Breaching Confidentiality
With the patients consent, Justifiable situations: Emergencies: To prevent a threat to the life or health of individual Statutory Requirement Public Interest Public Health
Reporting notifiable diseases
Think..Benefit/Harm
-What is the Public Interest? -What about sharing information about uncommon incidences/practices? -How much information should be disclosed? Name, age, residence..etc
Legal Consideration
Legal Consideration-OMAN
Rules & Regulations to Practice of medicine and Dentistry in Sultanate of Oman , 22/1996 : The doctor should not disclose patient confidentiality unless he obtains the consent of the concerned person. He may disclose it to a close relative such as parents adult son either for the seriousness of the patient ailment, or any other justified reason, he may also disclose it for the sake of preventing or uncovering a crime, or if he suspects that the patient is suffering from any of the stipulated communicable diseases, he should notify the concerned authority either spontaneously or 45 upon its request. If the doctor is assigned by a life insurance company to assess the clients he should disclose the confidentiality to the company only.
Penalties:
[a] warning [b] suspension from the practice for a maximum period of one year. [c] cancellation of the license and registration.
Case 1
Your cousin was admitted to the emergency room during your shift at the hospital. He is in critical condition. Your mother is very concerned about him, but she has not been able to reach your aunt and uncle. You know about your cousins condition. Do you tell your mom?
Case 2
A baby is brought into the emergency room. It is obvious that the baby has been physically abused. There are cigarette burns, Wasem scars and bruises all over his body. The hospital is swarming with media. A reporter has asked you for details. What do you do?
Case 3
You see a co-worker at the supermarket. She wants to talk about a particularly difficult patient. She is being very specific, using the patients name and condition. She even goes as far as to say a nuisance this patient is because the patient is so demanding. What do you do?
Thank you.