7


When something goes wrong A


breach of confidentiality is not something that can be corrected – once information has been disclosed, it is clearly not possible to “undisclose” it. In some respects,


that makes your response more straightforward. ■■ Establish what happened and what went wrong. ■■ Get in touch with the patient(s) to explain what has happened, and apologise if necessary.


■■ Give an assurance that lessons have been learned and identify how such a mistake can be avoided in the future.


Further information


Medical Council, Guide to Professional Conduct and Ethics for Registered Medical Practitioners, www.medicalcouncil.ie


Department of Health and Children, Children First: National Guidelines for the Protection and Welfare of Children, www.dohc.ie GP trainee section of the MPS website, www.medicalprotection.org/gptrainee


Questions


1. The family of a deceased patient makes a complaint against you and they have a number of aspects of care they are unhappy with. Can you discuss the medical treatment leading up to the death?


A. Yes, if a consent form was signed before death. B. No, this would be a breach of confidentiality.


C. Yes, patients and their families are entitled to honest, open and prompt communication about adverse events, and an explanation of what happened.


D. No, you should never discuss medical treatment with anyone other than the patient.


2. The Gardaí ask you for the medical records of a two-year-old patient, whom they suspect has been physically abused. They also ask for the mother’s records. Can you share the records without parental consent?


A. No, let them get a court order.


B. You should ask the Gardaí to seek the consent of the mother for both sets of records. If they do not obtain this you should not release the mother’s records, but you may release the baby’s since a serious crime is being investigated.


C. Yes, if the request comes from a senior officer. D. Yes.


Case scenario


What’s in a name? During a consultation with a patient, John Y, you refer to his recent HIV test, which was negative. He is confused, as he has not been tested at all, and you realise that the test is for a different patient, James Y. Unfortunately, as you are working out what has happened, you say to the patient: “Oh no, this test was for James Y, not John Y.” John Y knows James Y, and so you have breached confidentiality.


What should you do? You need to tell James Y about the mistake as soon as possible although, importantly, without revealing precisely how it happened (otherwise you will breach John Y’s confidentiality). It will be helpful to look at the procedures within the practice to look at how such a mistake could be avoided in the future.


3. A call centre HR manager comes to see you. She has brought in a sickness certificate for one of her employees, a patient of yours, which bears your signature. She thinks the dates have been altered. What should you do?


A. Refuse to see her, or confirm that he is a patient. B. You can confirm only that he is a patient.


C. You can confirm that the sick notes are not in their original state.


D. You can confirm that they are forgeries and remove the patient from your list.


For the answers to these questions, please visit the GP trainee section of the website, www.medicalprotection.org/gptrainee


CONFIDENTIALITY


GP TRAINEE | VOLUME 5 | ISSUE 2 | 2012 | IRELAND www.medicalprotection.org


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