Legal and Professional Issues - Manager of an IT company.

Patients

• Unspoken confidentiality agreement with doctor (doctor/ patient relationship)
• Date protection Act 1998 as before
• Human Rights Act 1998 as before
• Doctor- medical professional, patient- not a medical professional, thus the acceptance of something neither may no much about would potentially occur
• Names/ Address/ disabilities and/or illnesses being disclosed; private and personal information which could be very sensitive to the individual.

Enquires which may be carried out in order to understand the problem better

It would be beneficial to do all the following in order to understand the situation better:

• Contact the marketing company to gain a comprehensive understanding of the products; if not, the manufacturer.
• Conduct research to find out if the product(s) have been used elsewhere, and if so, what the results were.
• Contact the NHS; what are the regulations behind the marketing of products within medical practises.  As the governing body, has research been previously carried out on these products?
• Contact the General Medical Council who protect/ guide doctors and patients. With thorough knowledge of ethical guidance procedures for doctors and patients, they claim doctors should along with many other things;

• “Respect and protect confidential information [about patients]
• Respect patients' dignity and privacy
• Avoid abusing your position as a doctor”

• Speak to the doctors, ask them about the product and for them to speak to their peers in regard to the product- has others heard/used them.

Proposed ‘solution’ for the problem

There are a couple of steps that can be carried out in order to minimise the ethical dilemmas that are concealed within this problem;

1. The IT Manager [myself] could give the doctors details obtained from the company marketing health-related products so that they have the choice as to whether they carry out the advertising- it would then be their responsibility to ensure date protection.
2. The idea of disclosing patient information in my view [acting as the manager] is totally unethical, and will not even be taken into consideration; even with an incentive- it would put my profession as well as the medical practice under legal scrutiny.
3. The NHS could be contacted to see if it would be possible for the marketing company to operate through them, ensuring that nothing illegal/unethical is taking place, and thus increasing the financial position of the NHS, again, leaving the IT company out of the equation

Bibliography

• Computer Ethics Institute- Part of Brookings Institution

 

• Computers and Privacy- Bernhard Debatein

Cited on 25/10/2003.  Last site up-date

• General Medical Council

Cited 25/10/2003.  Last site up-date unspecified

• Integrity Works On Line

                 

        Cited 25/10/2003. Last site up-date unspecified

• ‘Privacy in the Information Age’ Smith. Graham K.  De Montford University, April 1994

Cited On 26/10/2003.  Last modified 28th October 1995

• Science Direct On Line Database

 

Cited on 2510/2003

• The Internet Encyclopaedia of philosophy 2001 - John Stuart Mills

 

Cited 25/10/2003.  Last site up-date unspecified

• The Observer On Line

Cited 12/10/2003.  Site up-dated daily

• The Voice of Doctors

Cited on 25/10/2003. Last site up-date unspecified

Appendices

John Stuart Mills

Born May 20th 1806 became a leading Philosopher of his time, formulating the ‘principle of utility’ involves an ‘assessment of only an action's consequences, and not the motives or character traits of the agent performing the action’

The Data Protection Act 1998

“An Act to make new provision for the regulation of the processing of information relating to individuals, including the obtaining, holding, use or disclosure of such information”                                                            [16th July 1998]

The Human Rights Act 1998

“An Act to give further effect to rights and freedoms guaranteed under the European Convention on Human Rights…”                       [9th November 1998]

Lives ruined as NHS leaks patients' notes 

Anthony Browne, Health Editor
Sunday June 25, 2000
 

 

Patients' lives are being ruined because of growing disregard for confidentiality. Medical records, detailing their most intimate and embarrassing secrets, are increasingly being passed around without their consent.

Doctors warn that scandalous abuse of records is now routine in the NHS, with dozens of different people in health authorities, local councils, universities, drug companies and medical schools being given access to confidential data. Doctors fear that patients would stop confiding in their GPs if they knew how many people would see their medical secrets. The Royal College of General Practitioners is so alarmed it is set to issue a warning.

In an internal briefing seen by The Observer, the chair of the ethics committee, Dr Iona Heath, declared: 'From a position of having been the guardians of confidentiality, medicine has now fallen far behind the highest standards, and routine practice now fails to fulfill the basic principles of data protection. There has been no public debate, and the public, as both citizens and patients, are mostly ignorant of the degree to which information is passed around.'

Health authorities now get names and addresses of patients for every treatment GPs give - they have lists, for example, of all patients' contraception. Medical records are sent to researchers to compile disease registers, and widely distributed to groups outside the NHS groups who conduct financial or clinical audits. Lists of women who have had hysterectomies are routinely compiled as part of the checks on cervical cancer screening services.

Medical researchers, including pharmaceutical companies, are regularly given medical records, including names. Medical students often get the name and medical history - and even tissue samples - of living patients, without their consent or knowledge.

Rita Pal, a hospital doctor who set up the pressure group NHS Exposed, said: 'Medical notes are in essence your life - how many affairs you have, if you have an alcohol problem, do drugs, your sexual activity, your psychiatric state. They are all very personal issues. Yet patients have no control over their confidentiality.'

Marion Chester, legal officer at the Association of Community Health Councils, said: 'Identifiable health records are flying around inside and outside the NHS at a rate of knots. It's getting worse, because of the increase in financial and clinical audit, and the increasing use of information technology. The attitude to patient confidentiality is very lax in the NHS.'

An Observer investigation has discovered:

• A 68-year-old man was refused a place in a care home when social services found from his medical records that he was gay.

• An uncle found out that his niece had a secret abortion when the company he worked for was asked to do a financial audit of the local health authority. He told her parents, who are very religious.

• A woman was sacked after her GP sent her records to her employer. The notes revealed that she had a history of mental health problems.

• Patients with medical conditions have been approached by researchers who have had access to their records.

• The medical histories of everyone living in Oxford are used without their knowledge by Oxford University for research. Names are removed, but patient groups claim individuals are identifiable through post codes.

• An MP was sent the medical records of a constituent without her consent. She found out only when the MP passed on the records to her.

There is also alarm that a new NHS-wide computer system to store patient medical records will erode confidentiality further. Chester said: 'Anyone who has access to the computer system and knows someone's NHS number will be able to get medical records.'

Ten Commandments Of Computer Ethics

Created by the Computer Ethics Institute 1992
 

Bernhard Debatin: Computers and Privacy

1 What is Privacy? 
 Quoted from , page 123

“Privacy is the ability to control one’s own circles of intimacy”

(Jurust A. F. Westin, Dietemann v.  Time

The concept of Circles of Intimacy (see  1998, p. 124)

---