A 56-year-old man is brought in by the police because he has developed chest pain whilst in their custody. He has been arrested on charges of burglary. He admits that he has a history of angina and hypertension. After you have taken your history and performed an examination, you are approached by a policeman, who asks to be informed of details from the consultation. The patient has asked for his case not to be discussed with anyone, including the police.
In this situation, it is not appropriate to breach confidentiality, which should be politely explained to the police officer.
2. If you are considering breaching patient confidentiality without a patient’s permission which two bodies should you seek advice from?
If you are considering breaching patient confidentiality, the patient’s consent should be sought first. If consent is refused, you should seek advice from your local trust (e.g. trust legal advisor) and your medical defence union.
3. List three examples of situations where patient confidentiality can be breached.
Examples of instances where confidentiality may be breached include:
- Cases where there is a legal obligation, e.g. informing the HPA of a notifiable disease
- Legal cases where there is a request for information from a judge
- Cases where there is a risk to the public, e.g. potential terrorism or serious criminal activity
- Cases where there is a risk to others, e.g. when a patient has expressed homicidal intent towards a specific person
- Cases relevant to statutory regulatory bodies, e.g. informing the DVLA of a patient that continues to drive despite a restriction