Medico-legal guide to
Confidentiality
3.1
Introduction and principles
Confidentiality is an essential part of When a patient gives consent, you must
the bond of trust that exists between only disclose information the patient has
doctor and patient. Failure to maintain agreed you may disclose, and only to the
confidentiality may mean a patient is third party that requested it. No other use
reluctant to reveal private or sensitive can be made of the information without
information that you may need to know seeking further consent from the patient.
in order to treat them appropriately.
Competent patients can give consent.
You have a legal and ethical duty to keep This includes children under 16 who are
all information relating to patients securely competent to make decisions (Gillick-
and not to disclose any information to competent).
third parties without a patient’s consent.
The only exceptions are when you are
required to disclose information by law Defining competence
or under your ethical or contractual To show competence, generally the
obligations. If you decide to disclose patient must:
information without consent, you should
be prepared to justify your decision. • have a general understanding of what
decision they need to make and why
they need to make it
General principles • have a general understanding of the
Confidentiality is a patient’s right and likely consequences of making or not
must be respected by the entire making the decision
healthcare team1. • be able to understand, retain, use and
You must get the patient’s express weigh up the information relevant to
consent before disclosing confidential this decision
information about them, or which might • communicate his decision – whether
identify them, to third parties, unless by talking, using sign language or any
the law allows or requires otherwise. The other means.
patient can give consent orally or in writing.
Every patient must be assumed to have
To give consent, the patient needs to capacity unless it is established that he
understand: or she lacks it2.
• who the information will be Patients who lack capacity (eg some
disclosed to patients with a mental disorder or young
• precisely what information children) require special consideration.
will be disclosed Any decisions to disclose should be
taken in the patient’s best interests.
• why the information is to You ought to consider what action will
be disclosed be likely to benefit the patient, as well as
• the significant foreseeable what you know about the patient’s views,
consequences.
Confidentiality
3.1
Introduction and principles
Confidentiality is an essential part of When a patient gives consent, you must
the bond of trust that exists between only disclose information the patient has
doctor and patient. Failure to maintain agreed you may disclose, and only to the
confidentiality may mean a patient is third party that requested it. No other use
reluctant to reveal private or sensitive can be made of the information without
information that you may need to know seeking further consent from the patient.
in order to treat them appropriately.
Competent patients can give consent.
You have a legal and ethical duty to keep This includes children under 16 who are
all information relating to patients securely competent to make decisions (Gillick-
and not to disclose any information to competent).
third parties without a patient’s consent.
The only exceptions are when you are
required to disclose information by law Defining competence
or under your ethical or contractual To show competence, generally the
obligations. If you decide to disclose patient must:
information without consent, you should
be prepared to justify your decision. • have a general understanding of what
decision they need to make and why
they need to make it
General principles • have a general understanding of the
Confidentiality is a patient’s right and likely consequences of making or not
must be respected by the entire making the decision
healthcare team1. • be able to understand, retain, use and
You must get the patient’s express weigh up the information relevant to
consent before disclosing confidential this decision
information about them, or which might • communicate his decision – whether
identify them, to third parties, unless by talking, using sign language or any
the law allows or requires otherwise. The other means.
patient can give consent orally or in writing.
Every patient must be assumed to have
To give consent, the patient needs to capacity unless it is established that he
understand: or she lacks it2.
• who the information will be Patients who lack capacity (eg some
disclosed to patients with a mental disorder or young
• precisely what information children) require special consideration.
will be disclosed Any decisions to disclose should be
taken in the patient’s best interests.
• why the information is to You ought to consider what action will
be disclosed be likely to benefit the patient, as well as
• the significant foreseeable what you know about the patient’s views,
consequences.
