Section 2 Confidentiality conundrums
Road rage raises confidentiality MDU advice
concerns
As a male patient tried to leave the surgery car The MDU adviser sympathised with the doctor’s dilemma
park, a woman drove in and parked in a ‘no and explained that this was a situation where the doctor
stopping’ area, obstructing the main exit. needed to balance the public interest against the need to
Oblivious to the angry blast of the male patient’s horn,
keep patient information confidential. She drew the
she extracted her shopping bags, presumably intending
doctor’s attention to the GMC’s booklet, Confidentiality:
to visit the supermarket across the road. The noise of the
Protecting and Providing Information (2004)
car horn attracted the attention of the surgery reception Paragraph 22 says, ‘Personal information may be
staff. They clustered around the window and witnessed disclosed in the public interest …...where the benefits to
the angry patient jump out of his car, run over to the an individual or to society of the disclosure outweigh the
woman and scream abuse at her. As she walked towards public and the patient’s interest in keeping the
the supermarket the male patient leapt forward and information confidential.’
kicked her. Leaving her on the ground he ran to his car
and reversed out of a side exit. The staff assisted the
Paragraph 27 states that ‘disclosure of personal
woman who was shocked and upset but not seriously
information without consent may be justified in the
injured.
public interest where failure to do so may expose the
patient or others to risk of death or serious harm.’It goes
The woman reported the assault and the police visited on to say that such disclosures may be justified to ‘assist
the surgery later that day, requesting disclosure of both in the prevention, detection or prosecution of a serious
the assailant’s identity and of his medical records. crime, especially crimes against the person.’
The senior partner telephoned the MDU advice line to The GMC also requires doctors to seek consent to
ask whether he should disclose the records and if so, how disclosure where practicable (paragraph 23). In some
much information he should provide. He told the adviser circumstances seeking consent may undermine the
that he had known the patient and his family for many purpose of the disclosure: for example, it might alert a
years and had always had a good relationship with them. thief to discard stolen prescriptions, or a doctor may be
He pointed out that the patient was under a lot of stress. placed at risk, for example, from a violent patient. But in
He had recently lost his job and had a severely autistic this case it seemed that the doctor had a good relationship
eight-year-old son. with the patient. The adviser suggested that he might
The doctor felt that while it was in the public interest
wish to contact the patient and talk things over with
that the assailant be identified to the police, he was
him, encouraging him to identify himself to the police.
uncomfortable doing this without the patient’s The adviser recommended that, if the patient would not
knowledge. He was also concerned that if he disclosed identify himself or consent to the information being
the records it could destroy the patient’s trust in the disclosed to the police, the GP might provide the
doctor and undermine the doctor-patient relationship. minimum amount of information in order to identify the
patient. For example he might disclose the patient’s
name and address. The adviser cautioned against
disclosing any medical information or the medical
records. The doctor was also advised to inform the
patient before disclosing the information.
Later that day, a relieved and grateful doctor telephoned
the MDU adviser to tell her that he had contacted the
patient who had been extremely remorseful for his
actions and had visited the police station himself to
confess to his crime. The doctor was pleased that he had
not been required to disclose the information and thanked
the adviser for the opportunity to discuss these issues.
“…it could destroy the patient’s
trust in the doctor and undermine
the doctor-patient relationship.”
21
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