sp confidentiality and ethical basis

7/29/2019 SP Confidentiality and Ethical Basis

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PREPARED BY :

AHMAD SAFUAN & SAQAR

PRESENTED BY :

NIK FARZANA BINTI NIK RAHMAT

AIN SYAFIQAH BINTI CHE GHANI

NUR FARAH ATIKA BINTI MOHD SAID


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1-Doctor-Patient (DR-P) Relationship.2-Types of Doctor-Patient (DR-P) Relationship.

3-Medical Confidentiality.

4-Doctors & Patients Barriers to Effective Communication.

5-Doctors Professional Role.

6-Breach of Confidentiality.

7-Rules for Disclosure.

8-Reasons to Disclose Information.9-Ethical basis for getting info.

10-Conclusion.


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Def : Special relationship created when aprospective patient seeks the advice, care, or

treatment of a physician.

Also known as :

Client-professional

Practitioner-patient

Lay-professional encounter

The relationship between patient and physician, or

should be, is fidelity or trust


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Paternalistic:

(or guidancecooperation) relationship, involving highphysician control and low patient control where the

doctor is dominant and acts as a parent figure who

decides what he or she believes to be in the patients

best interest.Mutuality :

relationship is characterized by the active involvement

of patients as more equal partners in the consultation

and has been described as a meeting between experts.

Consumerist:

relationship describes a situation in which power

relationships are reversed; with the patient taking the

active role and the doctor adopting a fairly passive

role.


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Two major obstacles to good physician-patient

communication Difference of language If the physician and the patient do not speak the same language, an interpreter will be

required.

Difference of culture Because of different cultural understandings of the nature

and causes of illness, patients may not understand the

diagnosis and treatment options provided by their physician.In such circumstances physicians should make everyreasonable effort to probe their patients understanding ofhealth and healing and communicate their recommendationsto the patients as best they can.


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So: a non efficient relationship can occur if patientscontinue to adopt a passive role even when the

doctor reduces some of his or her control, with theconsultation therefore lacking sufficient direction.


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Confidentiality:

is the right of an individual to have personal

medical information kept private. Such

information should be available only to the

physician .


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Medical confidentiality does not cover only what apatient discusses with a doctor

But also :-Medical records.-X-Rays.-Lab reports.-Communications between patient and doctor.-Communications between patient and other

staff working with the doctor.

All these confidentiality will still continue even afterthe death of the patient.


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-Natural human desire for privacy.

-Fear of social embarrassment or disapproval.

-Fear of discrimination and stigmatization.

-Information misused against patient.-Builds confidence and open communication.

-Helps to reach the right diagnoses and provide

optimal treatment recommendations.

-Right to determine with whom, when and how muchof personal medical information is shared.


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-Lack of specific knowledge.

-Lack of counselling skills.

-Lack of time.

-Lack of appropriate resources.


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-Educational level.

Sex.-

Social class.-

Different languages.-


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-Know about and understand the rights of patients.-Be able to communicate with individuals and groups.

-Demonstrate the following attitudes and behaviour :

Accept the moral and ethical.

Respect patients regardless of their lifestyle, culture,

beliefs, race, colour, gender, sexuality, disability, age,

social or economic status.

Respect right of patients to be fully involved in care

decisions, including right to refuse treatment or take partin teaching/ research.

Recognise their obligation to understand and deal with

patients' healthcare needs by consulting them (and their

relatives or carers).


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Maintaining confidentiality is difficult in modern medicine

and usually it occurs due to carelessness of medical staff

and there are many ways for breaching patient's

information such as:- Conversations in or out of the clinic.

Computerized patient information.

Release of medical records and disclosure of information.

Fax and e-mail also present opportunities for confidentialityto be broken.

Elevator chatter.

Unguarded conversation with patients friends/relatives.


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There are few situations where breach theconfidentiality is justified. For examples :

o Many individuals require access to a patients health

records to provide adequate care to that person, andfor students to learn how to practice medicineo In different language used between caregivers and

patients, there is need to disclose the information to theinterpreters to facilitate information

o Other individuals need to be given information aboutthe patient in case of incompetent patients to makedecisions on their behalf and care for them


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Only use when absolutely necessary.-

Use the minimum required.-

-Everyone should be aware of their responsibilities.

Understand and comply with the law.-

-Getting explicit consent from the patient


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1.Healthcare reasons.

Parents (when child is unable to give informed consent).

2. Public interest.

Where there is risk of serious harm or death to the patient or

other people.3.Required by law.

Complaints committees

Child abuse

4.Required by statutory

-Drug addiction

-Births and deaths


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-Ethics, also known as moral philosophy, is a branchof philosophy that addresses questions about morality

that is, concepts such as good and evil, right and

wrong, virtue and vice, justice and crime, etc.

Below are the ethical basis for withdrawing informationfrom the patients :

We shall respect the rights of patients, colleagues, and

other health professionals and safeguard patient

confidential and privacy within the constraints of thelaw

Patients records, including even the identification of

the patients, must be protected with extreme care.


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We may release confidential information only with

authorization of the patient or under proper legalcompulsion.

Clinical and other materials used in teaching and

writing must be adequately disguised in order to

preserve the anonymity of the individuals involved Careful judgment must be made in order to include the

parents/guardian in the treatment of a minor.

Ethically, we may disclose only that information which

is relevant to a given situation. Avoid offering speculation as fact

Sensitive information is usually unnecessary


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When in the clinical judgment of the treatingpsychiatrist, the risk of danger is deemed to be

significant, the psychiatrist may reveal confidential

information disclosed by patient.

When we are ordered by the court to reveal theconfidences entrusted to us by patients, we may

comply/ethically hold the right to dissent within the

framework of the law.

It is ethical to present a patient/former patient to apublic gathering /to the news media only if the

patient is fully informed of enduring loss of

confidentiality is competent.


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-All medical information that doctors

acquire as part of the professional

practice is subject to the Duty ofConfidentiality.

-Confidentiality is not absolute.

-Disclosure should only occur with consent,

for benefit of patient or with just groundsfor disclosure.


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