This document discusses medical ethics and legal medicine related to confidentiality and privacy. It begins by defining privacy and confidentiality, noting that privacy respects a patient's body while confidentiality respects their personal medical information. It then outlines various measures to protect patient privacy during medical examinations and treatments. The document also discusses the concept of medical secrets and the duty of confidentiality, the importance of which is enshrined in ethics codes and laws. Exceptions to maintaining confidentiality are noted, as well as measures to protect confidential information and ensure it is kept private.
Lecture 13 privacy, confidentiality and medical recordsDr Ghaiath Hussein
A lecture on privacy, confidentiality and medical records delivered to Alfarabi Medical College undergraduate medical students in the week starting 27.11.2016
Lecture 13 privacy, confidentiality and medical recordsDr Ghaiath Hussein
A lecture on privacy, confidentiality and medical records delivered to Alfarabi Medical College undergraduate medical students in the week starting 27.11.2016
The presentation explains the principles of medical ethics and describes important terms on the subject. Brief descriptions of codes of medical ethics are covered but for details actual documents may be referred.
A training powerpoint presentation for employees in patient confidentiality as a follow up on multiple breaches of confidentiality and privacy of protected health information of celebrities in a hospital setting.
Confidentiality can be defined as the
ethical principle or legal right that a
physician or other health professional will
hold secret all information relating to a
patient, unless the patient gives consent
permitting disclosure.
This is a slideshow explaining the importance of protecting patient privacy and confidentiality. This slideshow is for education and training purposes only.
Now-a-days public are expecting Skills, Knowledge as well as Ethical behaviour from Doctors. This PPT gives the 2 basic principles of Bio-ethics in brief & apt form
The presentation explains the principles of medical ethics and describes important terms on the subject. Brief descriptions of codes of medical ethics are covered but for details actual documents may be referred.
A training powerpoint presentation for employees in patient confidentiality as a follow up on multiple breaches of confidentiality and privacy of protected health information of celebrities in a hospital setting.
Confidentiality can be defined as the
ethical principle or legal right that a
physician or other health professional will
hold secret all information relating to a
patient, unless the patient gives consent
permitting disclosure.
This is a slideshow explaining the importance of protecting patient privacy and confidentiality. This slideshow is for education and training purposes only.
Now-a-days public are expecting Skills, Knowledge as well as Ethical behaviour from Doctors. This PPT gives the 2 basic principles of Bio-ethics in brief & apt form
SCHS Topic 5: Privacy, Confidentiality and Medical RecordsDr Ghaiath Hussein
Series of lectures I gave for the PEER (Professionalism and Ethics Education for Residents) Project sponsored and organized by the Saudi Commission for Health Specialties (SCHS).
OUTLINE:
Definitions and differences
How to maintain the privacy of our patients?
How to maintain the confidentiality of our patients’ information?
When to disclose medical information
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
3. Privacy :
A right or expectation to not be interfered with
- Be free from surveillance
- A moral right to be left alone.
RESPECTS PATIENT’S BODY
Confidentiality :
Is the right of an individual to have personal, identifiable
medical information kept out of reach of others.
RESPECTS PATIENT’S INFORMATION
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4. MEASURES TO PROTECT PRIVACY
1) Make sure examination takes place in isolation from other
patients, unauthorized family members, and/or staff
2) Provide gender-sensitive waiting and examination rooms
3) Provide proper clothing for the admitted patients
4) Make sure patients are well covered when transferred
from one place to another in the hospital
5) Make sure your patient’ s body is exposed ONLY as much
as needed by the examination or investigation
6) Patients should have separate lifts and be given priority
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5. MEASURES TO PROTECT PRIVACY
7) Always take permission from the patient before
examination
8) Insure privacy when taking information from patients
9) Avoid keeping patients for periods more than required by
the procedure.
10) It ’s prohibited to examine the patient in the corridors or
in the waiting area.
11) During examination, no foreign person unrelated to the
patient allowed
12) Give patients enough time to expose the part with pain
13) Only relevant personnel are allowed to enter the
examination room 5
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6. MEDICAL SECRET
Medical secret is defined as:
“ Any medical information that comes to the knowledge
of the practitioners as a result of their work whether
directly obtained from the patient, or otherwise”
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7. MEDICAL SECRET
It includes any information that the doctor (or
treatment team) knows about the patient (alive or
dead), directly or indirectly that a patient may deem its
disclosure undesirable or harmful to his/her health,
reputation, financial, social or professional status.
It includes any information about the patient ’ s identity,
condition, diagnosis, investigations’ results, treatment,
and/or prognosis (whether chances of cure, disability, or
death)
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8. PRIVACY IS VALUED IN ETHICS AND LAW
Protecting someone’s privacy involves protecting them
from unwanted access or control by others.
In this way it is linked with personal autonomy and it is
also viewed as a key element of personal identity.
Privacy can be thought of in terms of five dimensions:
1. Physical privacy
2. Informational privacy
3. Decisional privacy,
4. Personal property
5. Expressive privacy.
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9. 1. Physical privacy
Protecting patients’ physical privacy will alert staff to:
• Introduce physical touch with request and explanation.
• Minimize the duration and the extent of exposure.
• Minimize or get permission for the bedside presence of
medical/nursing students, spectators, or cameras
producing photographs for study purposes
• Provide explanations to patients of what happens during
times when they are unconscious
• The importance of expanding the number of single over
shared hospital rooms
• The sensitivity of many patients to rooms of mixed sexes
• The possible preference of some patients for doctors or
nurses of their own sex .
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10. 2. Informational Privacy
Secrecy, confidentiality, anonymity and protection of patient
data
3. Decisional Privacy
Patients can expect to be allowed, if not encouraged, to
make their own decisions and act on their decisions if they
so choose free from state, governmental or health
professionals interference
Concerns responsibility for very important choices about
treatment, termination of treatment, and involvement in
clinical trials
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11. 4. Personal Property
Includes all of a patient’s personal belongings and,
especially, those items that are considered by them to be
most important, e.g., personal diaries, letters, handbags
and wallets.
5. Expressive Privacy
Protects a region for expressing one’s self-identity or
personhood through activity or speech.
Self expression is critical for lifestyle choices that
contribute greatly to defining oneself and one’s values.
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12. WHAT IS CONFIDENTIALITY?
“The ethical principle or legal right that a physician or
other health professional will hold secret all
information relating to a patient, unless the patient
gives consent permitting disclosure”
“The nondisclosure of information except to another
authorized person”.
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13. WHY IS THERE A DUTY FOR CONFIDENTIALITY?
Trust between patients and health professionals.
Patients give information about their health in
confidence.
Individuals will be encouraged to seek appropriate
treatment and share information relevant to it.
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14. Because it has long been held as an honored bond between
health professionals and patients, the keeping of
confidentiality has been enshrined in both professional and
legal codes.
It was first articulated in the Hippocratic Oath (c.5Th
Century BC):
‘What I may see or hear in the course of the treatment or
even outside of the treatment in regard to the life of
men, which on no account one must spread abroad, I will
keep to myself, holding such things shameful to be
spoken about.’
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15. CONFIDENTIALITY IS PROTECTED BY PROFESSIONAL CODES
AND LAWS
Ancient and modern medical and nursing codes stress
the duty of confidentiality as a ‘time honored principle’
that extends beyond death.
Health professionals are also legally obliged to protect
patient confidentiality under the common law: legal
sanctions are in place for breaches of patient
confidence.
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16. CONFIDENTIALITY IN THE HEALTHCARE SETTING
All information about one’s patient is confidential.
This means not only their health situation but also,
living situation, family, and finances.
As part of the Health Insurance Portability and
Accountability Act (HIPAA): healthcare organizations
must make sure that patient’s medical information
remain safe and confidential .
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17. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY
ACT (HIPAA)
The Health Insurance Portability and Accountability Act of
1996 (HIPAA) is a federal law that required the creation of
national standards to protect sensitive patient health
information from being disclosed without the patient's consent
or knowledge
Assures that individuals’ health information is properly
protected while allowing the flow of health information needed
to provide and promote high quality health care and to protect
the public's health and well being.
Applies to health plans, health care clearinghouses, and to any
health care provider who transmits health information.
Protects all individually identifiable health information held or
transmitted by a covered entity or its business associate, in any
form or media, whether electronic, paper, or oral .
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18. THING THAT SHOULD BE KEPT CONFIDENTIAL
Name
Address
Birth date
Social Security Number
Phone number
Medical record number
Diagnosis
Treatment
Prognosis
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19. CONFIDENTIALITY MEASURES
1) Limit the accessibility to the medical records
2) Do not discuss the patient’ s medical information with
unauthorized family members
3) Do not disclose patient’ s information without his/her
consent, or in established exceptions
4) Do NOT collect information not related to the
provision of care
5) Set policies that regulate access to medical
information and how any breach to confidentiality is
managed
6) Limit sharing of information with other staff, unless in
cases of consultations and second opinion
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20. CONFIDENTIALITY MEASURES
In all records
Never inappropriately access records;
Shut/lock doors, offices and filing cabinets;
Query the status of visitors/strangers;
In manual records
Hold in secure storage;
Tracked if transferred, with a note of their current location
within the filing system;
Returned to the filing system as soon as possible after use;
Stored closed when not in use so that the contents are not
seen by others;
Kept on site unless removal is essential.
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21. CONFIDENTIALITY MEASURES
In electronic records
Always log out of any computer system or application
when work is finished;
Do not leave a terminal unattended and logged in;
Do not share Smartcards or passwords with others;
Change passwords at regular intervals;
Always clear the screen of a previous patient’ s
information before seeing another.
Email and fax
Whenever possible, clinical details should be separated
from demographic data;
All data transmitted by email should be encrypted 21
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22. TIPS FOR MAINTAINING CONFIDENTIALITY
Only view information on patients that you are directly
providing care to.
After viewing confidential information on the computer,
log off so others cannot view the information.
Avoid discussing a patient’s care in non-private areas
,examples: elevator, hallway or cafeteria. You never
knows who is listening.
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23. TIPS FOR MAINTAINING CONFIDENTIALITY
Be careful of what you throw away.
Personal health information should never be disposed of
in the trash can.
Any document thrown in the trash is open to the public
and therefore a breach of information.
Think before you speak.
Is what you are about to say confidential?
If so is the person you are speaking to part of the
patient’s healthcare team?
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24. IF PATIENTS LACK THE CAPACITY TO CONSENT TO SHARING
INFORMATION
Health professionals may need to share information with
relatives, friends in order to enable them to be involved in
decisions about the patient’s best interests.
The sensitivity of the information and any known wishes of
the patient in regard to it must be taken into account.
While hospitals may routinely seek the consent of the ‘next of
kin’ in relation to a decisions, this consent has no legal basis.
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25. WHAT IF A FAMILY MEMBER ASKS HOW THE PATIENT IS
DOING?
While there may be cases where the physician feels naturally
inclined to share information, such as responding to an
inquiring spouse, the requirements for making an exception
to confidentiality may not be met.
If there is not explicit permission from the patient to share
information with family member, it is generally not ethically
justifiable to do so.
Except in cases where the spouse is at specific risk of harm
directly related to the diagnosis, it remains the patient's (and
sometimes local public health officers’), rather than the
physician's, obligation to inform the spouse.
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26. DISCIPLINARY ACTIONS FOR BREACHING PATIENT
CONFIDENTIALITY
Disciplinary actions for breaching patient confidentiality can
range from fines to termination of employment, depending
on the extent of the breach.
Be aware that you can be held liable even if you give out your
patients’ personal information by mistake.
In June 2010 five California hospitals were issued
administrative fines and penalties totaling $675,000 after it
was determined they'd failed to prevent unauthorized access
to confidential patient medical information.
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27. CONSIDERING THE DISCLOSURE
You may disclose personal information if it is of overall
benefit to a patient who lacks the capacity to consent.
When making the decision about whether to disclose
information about a patient who lacks capacity to consent,
you must :
a) make the care of the patient your first concern
b) respect the patient’s dignity and privacy
c) support and encourage the patient to be involved, as far as
they want and are able, in decisions about disclosure of
their personal information
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28. THE FIVE C'S OF CONFIDENTIALITY AND HOW TO DEAL
WITH THEM
Consent—A clinician may release confidential information with the
consent of the patient or a legally authorized surrogate decision
maker, such as a parent, guardian, or other surrogate designated by
an advance medical directive.
Court Order —A clinician may release confidential information
upon the receipt of an order by a court of competent jurisdiction.
Continued Treatment —A clinician may release confidential
information necessary for the continued treatment of a patient.
Comply with the Law —A clinician may reveal confidential
information in order to comply with mandatory reporting statutes
(e.g., child abuse), and other such lawful purposes.
Communicate a Threat —This is the well known Tarasoff exception
to confidentiality that involves the clinician's duty to protect others
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29. CONDITIONS TO DISCLOSE MEDICAL SECRET
1) Approval from the patients within the limit given in the
approval
2) If the information are required by judiciary
3) Consultation or second opinion.
4) Notification of events of public health interest/threats
(birth, death, notifiable diseases, etc.)
5) Prevent individual/personal threats (e.g. prevent crimes)
6) If needed by the doctor to defend him/herself before
judges, or discipline committee
7) If the patient consciously and truly admits committing a
crime on which another person was accused/punished
Remember: Disclosure should be only to the concerned party & not
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30. THE DUTY OF CONFIDENTIALITY EXTENDS BEYOND DEATH
Guidelines that protect living patients equally apply after
patients have died.
Exceptions to confidentiality also equally apply.
International guidelines governing the release of medical
records of deceased patients generally consider:
the known wishes of deceased patients in relation to their
information.
the impact of non-disclosure on the wellbeing and welfare
of third parties – avoiding harming them or benefitting
them.
the impact of disclosure on the reputation of the
deceased; the possibility of anonymising the information. 30
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31. DECEASED PATIENTS
Your duty of confidentiality continues after a patient has died .
Whether and what personal information may be disclosed after a
patient’s death will depend on the circumstances.
If the patient had asked for information to remain confidential, you
should usually respect their wishes.
If you are unaware of any instructions from the patient, when you
are considering requests for information you should take into
account:
Whether the disclosure of information is likely to cause distress
to, or be of benefit to, the patient’s partner or family
Whether the disclosure will also disclose information about the
patient’s family or anyone else
Whether the information is already public knowledge or can be
anonymised or coded, and
The purpose of the disclosure’
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Dr.
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Abo
Ali
32. CASE
Your 36-year-old patient has just tested positive for HIV.
He asks that you not inform his wife of the results and
claims he is not ready to tell her yet.
What is your role legally? What would you say to your
patient?
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Medical
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Dr.
Rami
Abo
Ali
33. CASE DISCUSSION
Because the patient's wife is at serious risk for being
infected with HIV, you have a duty to ensure that she
knows of the risk.
While public health law requires reporting both your
patient and any known sexual partners to local health
officers, it is generally advisable to encourage the
patient to share this information with his wife on his
own, giving him a bit more time if necessary.
33
Medical
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Dr.
Rami
Abo
Ali