3401_Slides_Week 5 Confidentiality_Moodle (1)

WINTER Week 5 – Privacy and Confidentiality

• Instructor: Susan Stevens, BSW, MEd, RSW, CHE, EXTRA Fellow

• Position: Adjunct Professor & Part-time Faculty, Department of Family Studies and Gerontology

Today’s Class

Topics Covered

• Privacy

• Confidentiality

• Interpersonal communication

• Duty to warn and protect

Required Reading

• Bryan, V. et al. (2022). The helping professional’s guide to ethics: Theory in practice (2nd ed.). Oxford University Press.

• Chapter 4 – Confidentiality and the Duty to Warn and Protect

• Course: MSVU FSGN 3401 Contemporary and Professional Ethical Issues in Families and Aging

Learning Outcomes

• Moral Parameters: Describe the moral dimensions of privacy and confidentiality.

• Harms from Breaches: Identify potential harms from violations of confidentiality.

• Professional Duty: Explain the duty to prevent such harms or justify violations morally.

• Application of Principles: Apply common morality analysis to confidentiality management cases involving protected health information.

Importance of Confidentiality

• Essential Role: Confidentiality functions to foster trust between professionals and clients.

• Establishes Trust: Creates an environment where sensitive information can be shared honestly.

• Role in Treatment: Necessary for developing appropriate treatment plans.

• Prevents Harm: Avoids distress and encourages individuals to seek necessary services without fear.

Harms Caused by Confidentiality Breaches

• Distrust: Leads to distrust in professionals and related systems.

• Distress and Harm: Individuals may experience psychological impacts.

• Damage to Relationships: Breaches can harm therapeutic relationships.

• Behavioral Changes: Clients may lie or avoid services to protect themselves.

Definitions

Privacy

• Access Control: The right to control access to oneself or personal information.

Confidentiality

• Moral and Ethical Obligation: The duty to protect information shared in a professional capacity, highlighted in Bryan et al. (2022).

Moral and Professional Obligations

• Core Principles: Do not deceive, cheat, or breach the law. Maintain promises and uphold moral duties.

• Confidentiality Promise: Uphold confidentiality except when legal exceptions apply or when disclosure prevents harm.

Professional Codes of Ethics

• Respect for Privacy: Upholding confidentiality is a primary ethical obligation.

• Limitations: Acknowledge when and how confidentiality can be breached legally or ethically.

Legal Obligations Associated with Confidentiality

• Privacy Laws: Govern the ethical management of personal information.

• Other Legal Duties: Include court orders and child protection laws.

Confidentiality Characteristics

• Absolute vs. Relative Confidentiality: Understand contexts where information may or may not be shared.

Exceptions to Confidentiality

• Reasons for breaching confidentiality include:

  • Client’s permission

  • Risk of harm (e.g., child/youth protection)

  • Legal obligations (e.g., subpoenas)

  • Emergencies involving safety risks.

Duties to Warn and Protect

• Legal Framework: Based on case law (e.g., Smith v. Jones, 1999) which clarified when breaches may be permissible to protect individuals or the public.

Moral Parameters of Privacy & Confidentiality

• Justified vs. Unjustified Violations: Explore conditions under which privacy violations might be rationalized.

Confidentiality and Youth

• Specific Challenges: Working with ages 14-18 regarding capacity to consent.

• Age and Rights: Legislation outlines youth rights relating to confidentiality in health care.

Consent and Capacity Guidelines

• Assessing maturity and decision-making capabilities are crucial in determining confidentiality rights.

• Engage with minors in understanding their right to confidentiality, especially concerning their health information.

Issues and Concerns

• Lack of clear policies and protections for health providers regarding confidentiality issues particularly involving minors.

• Encouragement for health providers to maintain a safe space for youth to share information without fear.

Next Week's Focus

• Topics will include:

  • Capacity

  • Competency

  • Living at risk

  • Legal context

• Required Reading: Bryan, V. et al. (2022). Chapter 5 – Competency.