Dentistry at a Glance (eBook)

Elizabeth Kay (Herausgeber)

eBook Download: EPUB

2016
John Wiley & Sons (Verlag)
978-1-118-62949-9 (ISBN)

Infos

A fully illustrated, concise and accessible introduction to the study of dentistry 

• Central title in the At a Glance series for dentistry students
• Covers the entire undergraduate clinical dentistry curriculum
• Topics presented as clear double-page spreads in the recognizable At a Glance style
• Contributions from leading figures across the field of dentistry
• Companion website with self-assessment MCQs and further reading

Professor Elizabeth Kay is Foundation Dean of Peninsula Dental School and Faculty Associate Dean of Plymouth University Peninsula Schools of Medicine and Dentistry. She is Honorary Consultant in Academic Public Health and Chair of the Royal Cornwall Hospitals Trust's Membership and Engagement Committee. She sits on the British Dental Association's Committees for both Dental Public Health and Health and Science. She is also Oral Health Expert to two NICE Public Health Advisory Committees. She is also Trustee and Vice Chair of the British Medical and Dental Schools Trust and a Trustee of the British Dental Health Foundation.

Textauszug

2 Patient confidentiality

 

Any information that a patient has entrusted to you in your professional capacity remains the property of the patient. Failing to keep that information safe and secure, or passing it on to others without the patient’s knowledge and agreement, is a breach of the professional trust that the patient has vested in you. Not only would this violate a fundamental ethical principle, but many forms of inappropriate disclosure would also be a criminal offence, under Data Protection legislation.

Patients disclose many different kinds of information to us in the course of our professional relationship with them – some of it being of a sensitive personal nature. Additionally, they will often allow us to capture less obvious forms of information about them, such as study models, X-rays and clinical photographs. In all these cases, they do so in the trust and expectation that we will keep this information safe, and only hold and use it in association with their own dental care and treatment unless they specifically agree otherwise.

Some of the information we hold regarding a patient may already be in the public domain, for example their name, address and phone number may appear in a public directory. But if we have been given this information by the patient within the confidentiality of our professional relationship with them, the fact that it may also be in the public domain for other reasons does not diminish our own ethical obligations in relation to that same information. The underlying principle is that it will always remain the patient’s information, not ours (Figure 2.1).

Figure 2.1 Diagram illustrating the flow of information and the escalating level of controls required (green>amber>red). The patient must agree to the onward sharing of information at each point represented by the three coloured arrows. Specific consents may be required in certain situations (refer to text and Tables 2.1 and 2.2)

Secondary information

We hold other forms of information, such as the fact that the patient attended (or is due to attend) the practice at a particular date and time. We may know what job the patient does or which company they work for. We may know the names of other people in the patient’s family. Even the simple fact that the patient is under your care is information that you have no right to pass on without the patient’s agreement.

Permission

The patient may give us permission (consent) to pass on to a third party some or all of the information that they have disclosed to us, for a purpose directly related to their dental care, for example when being referred to a hygienist or a professional colleague elsewhere. They may also allow us to use some of this information for a purpose unrelated to, or secondary to, their own dental care (Table 2.1). In all these cases the patient must be fully aware of the purpose for which the information will be used, the context in which it will appear, who will have access to it, for how long/ how often, etc.

Table 2.1 Secondary uses of confidential patient information, unrelated to their own care and treatment

Research

Supplying information about the patient and their dental/oral status for the purpose of a bona fide research project (e.g. one which has been approved by a recognised research ethics committee) may be justified in appropriate circumstances.

Lectures and publications

Patient information and images of a patient might be used within professional/ academic circles for the purposes of education through discussion of case studies, published articles, seminars, and lectures at courses and conferences.

Practice promotion/ marketing

The use of images of a patient (especially but not limited to those from which they might readily be identified) for advertisements, printed marketing material, websites etc. This would include any quotes from the patient used for the same purposes.

Mailing/ communications

A mailing house might be provided with the names and addresses of a group of patients (and/or their email address) for the purposes of a direct mailing of paper communication or email campaign.

Audit and investigation

Third-party payment agencies and health insurers may wish to be provided with patient records in order to satisfy themselves as to the treatment provided, details of any payments made by the patient etc. The patient may have provided a qualified or absolute consent to this when applying for treatment and details of this should be sought before releasing any information.

The specific agreement of the patient is needed for any of the above, for each occasion when the information is used. If the intention is to use the information on more than the one occasion for which their permission was originally sought, the patient must have agreed to this at the outset.

If the patient consents to (for example) an image of their mouth and teeth being used in a professional/ academic setting for the specific purposes of one or more lectures to be given by a specific dentist, it is not then acceptable for that dentist to use the same image for an entirely different purpose such as ‘before’ and ‘after’ images placed on a practice website. It is even less acceptable for the image to be passed on to anyone else, and used for any other purpose, if the patient did not give their agreement in the expectation that this would happen.

Exceptions

Most of the time, the principles and duties of confidentiality will be clear and obvious. There are, however, some other instances where it is not possible, or perhaps not always necessary, for the specific agreement of the patient to be obtained before passing on confidential information about them. A common example arises when disclosing information about a minor (child) to their parent or someone else with a legal right to be provided with the information. Some other rare exceptions are listed in Table 2.2.

Table 2.2 Examples of situations where disclosure of confidential information about a patient to third parties may be acceptable in specific circumstances (advice should be sought from your indemnity provider regarding particular situations)

Disclosure to whom?

In what circumstances?

Safeguards

Tax authorities (HMRC)

To verify the date, amount and method of payments made to a dentist, and to corroborate a dentist’s tax claims. HMRC may wish to see a range of information including clinical and financial records, laboratory and supplier invoices which identify the patient.

Establish whether or not the same information can be provided without disclosing any records that might contain other sensitive personal information about the patient, unrelated to the tax investigation. HMRC should be asked to provide a formal notice under Section 19A of the Taxes Management Act 1970, citing the reason why the information is required.

Police officers

This may be:(1) for the purpose of corroborating an alibi given by one of your patients who is suspected of having been involved in committing a criminal offence;(2) to facilitate police enquiries into the whereabouts of a missing person;(3) to assist in the identification of a body.

(a) Here the patient’s right of confidentiality needs to be balanced against a legitimate public interest. The seriousness of the offence may be a consideration but there should normally be no objection to seeking the patient’s consent in writing to the disclosure.(b, c) In both of these cases you should ask for formal documentation to confirm the nature and scope of the police enquiry, and generally co-operate in the public interest.

Solicitors instructed to act on behalf of a patient (including children under your care)

Usually, when they are making or investigating a potential claim against you or somebody else who has previously treated the patient. But occasionally the request may be in connection with intimated divorce or child custody proceedings.

No information should be supplied without a full explanation of the circumstance in which the requested information is needed. The solicitors should also be asked to supply a specific written authority signed by the patient.

Teachers (in the case of child patients)

For example, to verify details of a child’s dental appointment(s) or the time when they arrived/left the surgery. This can occur where a child is citing their attendance at a dental appointment as the reason for them being absent from school.

In general this information should not be provided without the written authority of the parent(s) or person who has legal responsibility for the child. You should also ask for formal confirmation in writing that the enquiry is being made with the school’s knowledge and...

Produkt-Details

• Erscheint lt. Verlag: 18.2.2016
• Reihe/Serie: At a Glance (Dentistry)
• Reihe/Serie: At a Glance (Dentistry)
• Reihe/Serie: At a Glance (Dentistry)
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizin / Pharmazie ► Gesundheitsfachberufe
• Themenwelt: Medizin / Pharmazie ► Zahnmedizin
• Schlagworte: Clinical Dentistry • dentistry • dentistry student • Einführung i. d. Zahnmedizin • Einführung i. d. Zahnmedizin • General Dental Council • Illustrated • introduction </p> • Introductions to Dentistry • <p>At a Glance • undergraduate dentistry • Zahnmedizin
• ISBN-10: 1-118-62949-3 / 1118629493
• ISBN-13: 978-1-118-62949-9 / 9781118629499