3.2 Lead practice to address legal and ethical conflicts that arise between maintaining confidentiality and information sharing

Course: NVQ Level 5 Diploma In Leadership & Management for Adult Care

Unit 3: Communication & Information Management in Adult Care

LO3: Implement systems for effective information management

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Legal and ethical conflicts can often arise between maintaining the confidentiality and sharing information. When faced with such a conflict, it is important to lead with caution and carefully weigh the benefits and risks of both options before making a decision.

Maintaining confidentiality is essential in protecting the privacy of our clients and patients. However, there may be instances in which sharing certain information could help prevent or mitigate potential harm. In these situations, it is important to carefully consider all factors involved before making a decision.

This practice activity will allow you to demonstrate your ability to apply knowledge and understanding of confidentiality, data protection, information sharing (and data matching), with the relevant legislation or standards.

A relative of a patient attending your GP practice requests information about the patient’s visit. The relative is aware that such information will not be provided without consent from the patient but wants to know if their family member is current with their child care payments and how much they owe.

The practice is aware this would be in breach of confidentiality and data protection, but also wants to support the family so decides to give them an estimate of what their family member owes.

If the practice was to give the patient’s family an estimate of what would be owed, this could put them in danger. While the practice may be trying to support the family, by sharing this information they are putting themselves at risk of breaching confidentiality and data protection laws (and potentially assisting with money laundering).

Capacity issues

A patient of yours has just been admitted to the hospital after suffering a stroke. During your assessment of the patient, you note that their mental capacity is impaired on account of their current medical condition.

The practice is aware that under international guidelines, they should not seek consent from incapacitated patients for sharing information about issues that do not affect them directly (such as data matching, research & public health).

However, you were hoping to access their medical records (in order to provide continuity of care) and are unsure of what the practice should do next. If the patient’s records are not accessed it may place them at risk if they remain in the hospital for an extended period.

An ethical dilemma has presented itself to the practice and they need to work through the scenario and make a decision.

The practice decides that it would be appropriate to access the patient’s medical records (and decide how they wish to proceed). However, if the patient was admitted for an extended period of time it may be best to inform them of what is happening (in line with good health care).

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Next of kin vs nearest relative

A patient is admitted to the hospital and their next of kin (i.e., their spouse or partner) wants access to the information about his condition and treatment.

The practice wants to support the next of kin, but they also want to respect their privacy and protect data (and often this would be with the permission of the patient). However, if the next of kin does not consent to share information about their family member, the practice would need to explain why they cannot do so (as this would be against data protection laws).

In this case, the practice may choose to seek the nearest relative of the patient (assuming that is not their spouse or partner). This will be in line with guidance from data protection laws.

However, if a next of kin was deemed as a ‘nearest relative’ and they objected to what you were doing, it would be appropriate for the practice to consider whether the patient had the capacity and possibly seek their consent.

Power of attorney – lasting vs enduring

A patient has given a power of attorney to their spouse who now shares responsibility for their medical treatment. In this scenario, the power of attorney would usually be an ‘enduring’ one (meaning it remains valid until the patient revokes or loses capacity).

However, there is sometimes confusion over whether a lasting power of attorney would remain valid if the patient enters a care home or hospital. If the power of attorney was not for medical treatment, then it may be valid. However, if the power of attorney is for medical treatment, this would no longer be valid while the patient is being treated in the hospital.

This means that the power of attorney could only remain valid if they are admitted to the hospital as a private patient.

If this is the case, you should explain to your practice why they cannot rely on the power of attorney for medical treatment (and seek the nearest relative’s consent) if it is valid. You should also explain that if they are not happy with your decision, they can raise it at your next safeguarding meeting.

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