Some Examples

Below are just 5 examples of moral/ethical questions that need to be asked about medical privacy.

I decided to do this as a separate thing so that people who have an interest in such things, can see some basic questions that I have.
There are loads of examples, including the example of identifiable data being released from GUM clinics in England without patient consent that I could have put in, but I thought it best to start with the basics

It is because of these examples and the fact most patients are not aware of what is being shared (one patient pointed out that talking to a doctor was like talking to priest) that I get my back up. Informing patients does not take long. It can be as simple as printing off what the receptionist can see and showing that to the patient. Some patients might not be that bothered, but others would be. Some patients might not be that bothered about who sees their referral letter, test results for things like STDs/STIs (cervical smear test results are now held on one national database in Scotland without the informed consent of patients and despite the fact this database is not as secure as it should be) or who knows that they are on Viagra but others would be. It takes seconds to tell a patient that you dictate to a secretary who will know who you are and what is wrong with you, yet doctors and nurses seem to hate the idea of telling patients the truth. They give the impression that they keep info private, yet this is far from reality. Telling your doctor/nurse or any other health worker is far from ‘confidential’.

Example 1

A girl becomes sexually active but does not want anyone other that her GP knowing. In most practices, that would not be allowed. The girl then become pregnant but wants a termination. She is now faced with 3 choices.
1) Tell the GP and allow her (or him if they chose not to see a female doctor) to share the data.
2) Try and force a miscarriage and not report it.
3) Go to a back street abortionist which may not be done safely and she runs the risk of being abused.I for one think the latter 2 choices are dangerous and I find it appalling that the health profession seem to think these are 2 viable options.

Illegal abortions still take place in the UK. What has to be asked, yet the health profession refuse to ask, is, are illegal abortions taking place in the UK because the health profession refuse to allow access for legal abortions unless the woman agrees to inform others? If the answer is yes, then the health profession can/should be held responsible for illegal abortions. In other wards, the buck stops with the health profession.

Example 2

Parents decide to take out insurance, including insurance for their children. As part of the application the applicants must disclose medical data. One of the children says no and as a result the application is refused. The parents then use presure on the child and the child decides to say yes. Is that consenual? I don’t think it is. Whilst it is unlikely that a 4 year old will be able to make a informed choice, what about a 14 year old? 14 year olds can make life changing choices, so why can they be forced to realease data? If there is something they don’t want their parents or others to know, then they don’t have much chance of keeping it from them and should they be forced to tell others? Don’t chiildren have rights?If the parents want to make a claim for an injury but the child refuses to allow the GP to release some info and again parents apply pressure getting the child to change their minds and say yes, is that consenual?What if it was a case of a man/womans partner wanting the other to share data? Saying no to this could cause a breakdown in the relationship, which could involve children. Is that consensual?

What about children being lead to think that telling insurance compaines and evrybody else, such as employers is normal because that is what they have been lead to belive. I know this is a phylisophical question, but it is something that I have felt needs to be considered by doctors as they are often the only people standing in the way of people gaing access to our records (although with the new natuional databse, something that is to be removed with the introduction of a national database (it is interesteing to note that children seem to have been excluded from the national databases that ministers and doctors cliam will save lives and saying no will cause harm to pateints).

Example 3

A man is arrested for sexual abusing children, or ay other crime. The man is arrested and then questioned at which time he admits the crime. The only evidence the police have is the mans confession. The man is then charged and brought before the courts. At this point it is discovered that the man had not been read his rights after being arrested and had not been told he was under caution. He had also been lead to believe that what he had said before being arrested would ‘go no further’. Because his rights were breached, what he had said in the past could not be used as evidence, he then walks free.A patient. tells a doctor/nurse something under the impression that nobody else will know and unaware of the fact that the data would be used by others, such as for insurance or to determine if the idividual broke the law. The patient then finds out data latter date about this and the doctor then simply tells the patient this is the case and the patient can do nothing to stop it. If that means the patients would not have disclosed data or be examined, then that is tough luck, the patient has fewer rights than the criminal. If the patient happened to be a victim of the above crime and had sought help due to this, then that raises one big question. Why is it the patient has less rights? Their attacker walks free for not being told the truth, the patient simply has this back dated to allow data to be shared and accessed.I for one find that imoral, yet it gets done almost every day in the health profession.

Example 4

If I was to lead someone to believe that I was a doctor so that I could carry out an intimate examination on them, would it be an assault/ sexual assualt even if they agree to me touching them? I would say yes.If a patient was to allow a doctor to carry out an intimate examination because of they thought tht only the GP would know why they were there and what was wrong with them but the info was then known by others (ether from reading the info or from thr doctor dictating the info to them), would that be a assault/sexual assualt? Again I would say yes.A lie to touch is still alie no matter what your profession. This sort of assualt goes on almost everyday in the health profession, yet it goes un-punished

Example 5

If someone was to put a gun to someones head and demand sex, would that be rape? I think it would be even if the victim was to say yes, as saying no could result in their harm. If the gun was hidden away, but the patient knew it was there, would that still be rape? I would say yes. This is an implied threat by the attacker.Currently, in most practices, unless a patient agrees to data sharing (I have been in practices, such as Gilbert Road in Bucksburn, Aberdeen) where all doctors/nurses have full access to GP files, such as asthma clincs knowing if patients have ever been raped and in these pracices even admin staff are allowed to know which patient is on Viagra or been abused etc), the patient is not allowed access to health care even where this causes discomfort or even their death unless they ‘consent’ to data sharing. With the threat of discomfort or even death for saying no (said or implied), can the patient saying yes be of their own freewill? I for one say no as to be consentioanl you must be able to say no without it causing any side effects, and to me discomfort/death is a side effect. NHS Grampian and other NHS trust (even government ministers) seem to view the patients discomfort/death as a viable option for the patient.