11: confidentiality and consent

Why is confidentiality important?

• patients disclose private information

• breaches can cause distrust, legal implications and reluctance to share information

• the code

How to maintain confidentiality

• secure storage

• anonymise information

• be cautious with technology (avoif leaving screens unlocked/using personal devices for work)

• avoid casual conversations

confidentiality/consent in children (4-steps)

1) Assess Gillick competence

2) respect child wish (if Gillick)

3) or involve parents if necessary (explain to the child)

4) document decision-making process

what are the key principles of consent

• voluntary

• informed

• capacity

• ongoing

improving the informed consent process

• clear communication

• patient-centred

• use of tools (written information, multimedia resources, extended discussions)

• avoid nudging (compromise autonomy)

• RCC recommend comprehensive note-taking at each stage

7 GMC principles of consent/decision-making

1) patient involvement

2) ongoing dialogue

3) right to information

4) relevant information

5) presumption of capacity

6) best interest for lacking capacity

7) support for legal restrictions