Privacy and Confidentiality

Review and explain the concepts of confidentiality and privacy within healthcare contexts.
Explore ethical stances related to confidentiality and privacy.

Definition: Originates from the Latin term "fide" meaning trust.
Purpose: To keep patient information private during healthcare provision.
Legal and Ethical Standing: Upholding confidentiality is both a legal obligation and an ethical requirement:
- In Australia: Legislation is governed by the Privacy Act 1988, with a general duty of confidentiality recognized.
- In Singapore: Governed by the Personal Data Protection Act 2012, which includes healthcare applications.
Historically viewed as an absolute principle, though exceptions exist for moral or legal breaches.

Consequentialist Argument:
- Confidentiality encourages patients to seek treatment without fear of exposure for sensitive or illegal issues, leading to proper diagnosis and care.
- Aimed at minimizing harm and maximizing benefit (utilitarian justification).
Respect for Autonomy Argument:
- Emphasizes individual control over personal information disclosure, which is essential for personal freedom and achieving personal goals.

Definition of Fidelity:
- Refers to promise-keeping and is viewed as an ethical principle linked to patient trust.
Professional Codes:
- Many professional codes emphasize the necessity of maintaining confidentiality and privacy for patients.

ICN Code of Ethics (2021):
- Nurses must hold personal information confidential and exercise judgement in its sharing.
NMBA Code of Professional Conduct (2018):
- Clarifies that personal information obtained in a professional capacity is confidential, and nurses have ethical/legal obligations related to privacy.
- Exceptions only occur when legally justified or required for emergency care.

Breaches of confidentiality are permissible if keeping information secret could harm innocent parties.
It's essential that potential victims are informed about risks to make informed decisions.
Avoiding confidentiality breaches in such cases contradicts respect for others' autonomy.

Quote: “To keep silent regarding a patient’s confidences is to honor one of the oldest obligations in medicine.” (Bok, 2011)
Confidentiality should not be held where it may cause avoidable harm to others.
The right to confidentiality is forfeited when it compromises moral interests of innocent individuals.

Circumstances warranting breach include:
- Protecting others from violent individuals.
- Disclosure of HIV status to partners.
- Notifying about health practitioners (HPs) with infectious diseases if public safety is at risk.
- Addressing concerns related to genetic information.

Various state and federal acts govern the disclosure of confidential health information, such as the Health Records Act 2001 (Vic), which details when information can be disclosed or withheld.

Connection to Confidentiality:
- Privacy and confidentiality are related but distinct concepts.
Privacy Definition:
- The right to control information about oneself.
Access vs. Disclosure:
- Privacy issues pertain to access control while confidentiality deals with information use and disclosure.

Health Privacy Principles (HPPs):
- Allow for data collection/disclosure without consent to prevent serious threats to individuals' or public safety.
Regulatory Framework: Similar rules exist under the Commonwealth Privacy Act 1988, with procedures for addressing complaints and referring conduct to registration authorities.

Transition to electronic health records is a priority, exemplified by the Personally Controlled Electronic Health Record system (PCEHR), now My Health Record (MyHR).
Unique benefits: facilitates sharing of health information, but raises privacy and confidentiality concerns.
As of October 2022, over 23.4 million registered users.

Rapid increase in social media use creates ethical and legal challenges for healthcare providers.
Risks include unintentional violations of professional standards due to improper client interactions online.

Examples of potential violations:
- Texting drug orders or communicating via Facebook could breach ethical guidelines.
Legal consequences: breaches can lead to disciplinary actions from regulatory bodies.
Reminder: Privacy laws apply to all electronic engagements and confidentiality breaches can incur liability, even without patient identification.

Violations of professional conduct can lead to:
- Disciplinary actions by registration authorities.
- Employment consequences due to policy breaches.
- Potential criminal charges and personal liability.
Caution: Avoid sharing patient-related information unless absolutely necessary and legally authorized.

Cited works and authors, including ethics and law resources relevant to healthcare.

Additional citations relevant to healthcare ethics, law, and policy in Australia and Singapore.

Thank you note from La Trobe University with contact information for further inquiries.