Thread by @fascinatorfun

This seems to confuse duties of confidence to individuals that arise out of the relationship between medical professionals & patients (to which there are exceptions - rarely exercised), the disclosure of personal identifiable data that may apply to other organisations.

https://twitter.com/kallmemeg/status/1391282641064931330

In other words the starting point is the legal relationship between you and the individual.

The Dept of Health, for instance, has provided quite detailed guidance to people working in the NHS on this and also the rare exceptions.

assets.publishing.service.gov.uk/government/upl…

Of course duties of confidence (when they arise) have to be seen in the context of clear informed consent.

If the patient gives their INFORMED consent then the duty of confidence goes but is limited to the terms of the consent.

A patient might give consent for their case to be disclosed in training, for instance, but not to a newspaper.

Sometimes patients are keen to disclose for many reasons as we have seen on TV re Covid. They want others to know to take it seriously. Personal choices

There are rare instances where even without consent disclosures are permissible.

Here is a flow diagram from the Dept of Health Guidelines to NHS personnel.

Different duties of confidence MAY arise within other professions depending upon the category of material and/or their contractual or professional relationship to an individual or organisation.

What if the reason for the non disclosure is not to protect (say) patient confidence but to refuse suitably anonymised information to protect organisations from reputation all harm or political embarrassment?

That is a different matter.

So if there was just one person with a particular condition in a town removing their name from the information would not really anonymise it at all.

But to give details on how many pupils nationally or regionally have contracted Covid (for instance) (or a particular variant) in any one week when there have been several instances is hardly breaching confidence.

Indeed hiding it maybe to spare the blushes of politicians or those developing policy.

In those circumstances duties may arise with professionals who see untruthful accounts given leading to unsafe practice to blow the whistle .

Similarly with regard to unsafe policy.

There is nothing ethical about trying to hide that.

With regard to Covid there is a real public interest tension because this is a highly infectious disease and deadly for some. So the public in a particular area knowing they may be at risk is important and there are limits (as we know) to contact tracing.

But, for instance, if a parent, fellow pupils, a member of the public or journalist got to hear that a particular school was affected by Covid, or indeed a particular individual, and, in particular, a more infectious variant then would they be under any duty of confidence. No!

People may choose to be discreet about individuals.

But the main point is that duties of confidence are not as clear cut as the original tweet suggests and public interest disclosure was not addressed at all.

Also there are occasions when public safety and security may weigh in favour of disclosure.

We have seen instances where educational establishments seem to have failed to inform members of staff that they may have been exposed to the risk of Covid and failed to take adequate measures to protect staff.

Where does the public interest lie there?

https://twitter.com/fascinatorfun/status/1387350683221995523

Then there is the issue of when there are competing duties. A duty of confidence but also a duty of protection of others.

So a head teacher might have a contractual and ethical duty of confidence towards one pupil but he or she also has a duty of care towards all the other pupils, other teachers and their connected community (eg when an infectious disease has cropped up)

Which overrides the other?

I have to say that the chances of keeping there fact that one or more pupils or teachers have contracted Covid quiet in a school environment is small.

And if Covid has transmitted to other pupils/staff, good luck with keeping that quiet.

And should you?