In the context of Child Protection the Clinician is not always bound by patient confidentiality. The duty of confidentiality is overridden by public policy where a child is at risk of serious harm. The Clinician should recognize when it is appropriate to step outside patient confidentiality and take further action, including contacting the police, or social services.
The General Medical Council guidance "Good Medical Practice" (May 2001) states
"You must treat information about patients as confidential. If in exceptional circumstances there are good reasons why you should pass on information without a patient's consent, or against a patient's wishes, you must follow our guidance Confidentiality. Protecting and Providing Information and be prepared to justify your decision to the patient, if appropriate, and to the Courts if called on to do so."
Further GMC guidance is available, "Confidentiality. Protecting and Providing Information" (April 2004)
www.gmc-uk.org
The Nursing and Midwifery Council also provide guidance on confidentiality at paragraphs 5.1 to 5.4 of "The NMC code of professional conduct: standards for conduct, performance and ethics" (standards 07-04)
www.nmc-uk.org
5.1 "You must treat information about patients and clients as confidential and use it only for the purposes for which it was given"
5.4 "Where there is an issue of child protection, you must act at all times in accordance with national and local policies"
The Department of Health provides guidance in the "Essence of Care: Patient-focused benchmarking for health care practitioners" www.dh.gov.uk/Publications (Policy and Guidance) also see "Patient Confidentiality and Access to Health Records" and "NHS Confidentiality Code of Practice" at www.dh.gov.uk
The British Medical Association states
"The duty of confidentiality owed to a person under 16 is as great as the duty owed to any other person."
www.bma.org.uk
Dr Michael Wilks, Chairman, BMA Medical Ethics Committee states in the introduction to "Confidentiality and disclosure of health information" 14/10/99
"it is well recognized that patient confidentiality is desirable but not an absolute concept and can be breached if circumstances warrant such action."
The Medical Defence Union produces a Guide to Confidentiality available to members to download from www.the-mdu.com (Advisory and risk management publications)
The Royal College of Paediatrics and Child Health provides guidance in "Responsibilities of Doctors in Child Protection Cases with Regard to Confidentiality" February 2004
www.rcpch.ac.uk (pdf)
Further information:
This information is for educational purposes only and is not intended to substitute seeking legal or clinical advice where appropriate. For further legal information, please contact the Law Society of England and Wales at www.lawsociety.org.uk.
This guidance is produced by WardHadaway.
© WardHadaway