Balancing Duty and Public Interest

Jackie, as a medical professional, owes a legal duty of confidentiality towards Darren. Lord Phillips MR ruled that there is a duty of confidentiality between a doctor and their patient in regard to their condition and treatment. Jackie owes a duty to maintain confidentiality of the information obtained about Darren. According to Standards of conduct, performance and ethics, Jackie can only disclose confidential information in the public interest, including protecting public safety or preventing harm to Susan. Jackie has an overriding duty towards the society. As such, the confidentiality can be overridden in order to prevent serious harms to Susan. The duty of confidentiality is, thus, an important legal and ethical duty. However, it is no absolute right and Jackie can disclose the personal information to Susan about Darren. The General Medical Council provides that a disclosure can be justified in the public interest. Such disclosure must benefit Susan and the benefit must outweigh both Darren and the public’s interest. For instance, the disclosure is necessary to protect Susan from risks of serious harm, including serious communicable diseases, which is this case is HIV. Before disclosing, Jackie must consider whether or not it is practicable or appropriate to seek Darren’s consent. If she has already decided to disclose, she should tell Darren about her intention to disclose unless it is not safe or practicable to do so. Also, Jackie must also considered while balancing public interest and Darren’s interest, such as the potential harm or distress to Darren, potential harm to Susan in case of non-disclosure, or whether the potential harm could be avoided without breaching Darren’s patient’s privacy. In this case, Darren’s distress in case of disclosure cannot outweigh the harm to Susan that non-disclosure would cause. Jackie should disclose to Susan without information Darren about her intention to disclose.

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1. Ashworth Security Hospital v MGN Ltd. [2000] 1 WLR 515, at 527
2. Jonathan Herring, Medical Law and Ethics (Oxford University Press 2020) 266.
3. Health and Care Professions Council, ‘Standards of conduct, performance and ethics’ accessed 2 February 2020 .
4. Jonathan Herring, Medical Law and Ethics (Oxford University Press 2020) 147.
5. Ibid, 49.
6. General Medical Council, ‘Disclosing patients' personal information: a framework’ accessed 3 February 2021 .
7. Ibid.
8. General Medical Council, ‘Disclosures for the protection of patients and others’ accessed 3 February 2021 .
9. Ibid.

Doctor can only disclose patient information in exceptional circumstances such as under public interest. A justified disclosure must be limited to the minimum necessary in order to meet the need. Peter must be informed of the disclosure unless the consent will defeat the purpose of the investigation. If a health organisation has information relevant to the investigation and the disclosure is justified in public interest, such as serious threat to an individual health and safety, limited information can be disclosed. In an investigation of a crime, a medical professional will be obliged to disclose information unless that information is confidential patient material. Disclosure is justified if the police can give a detailed description of the person in relation to a serious arrestable offence and the person has received treatment in A&E department. Disclosure is justified if it prevents or detects crime. The GMC guidance, ‘Confidentiality: Protecting and Providing Information (2000) provides justified disclosure if it assists prevention or detection of a serious crime that can put a person at risk of death or serious harm. Applying the principles of confidential duty here, the question is whether or not Peter’s act of stealing the car and speed driving through the village constitutes serious offence. His act does not come under Serious Crime Act 2007, Schedule 1 definition of serious offences. Even though, Dr Soames and the Halesworth medical centre may have information about Peter, disclosing about Peter may not meet the justification of public interest. Non-disclosure may not lead to serious threat to an individual health and safety. As the crime is not a serious crime that puts a person at risk of death or serious harm, and the police did not give a detailed description of the person they were looking for, the disclosure of Peter’s information will not be justified.

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10. Hunter v Mann [1974] 2 WLR 742.
11. Bridgit Dimond, Legal Aspects of Patient Confidentiality (Mark Allen Group 2014).
12. Ibid.
13. Ibid.
14. Ibid.
15. General Medical Council, ‘Disclosing patients' personal information: a framework’ accessed 3 February 2021 .
16. Ashworth Security Hospital v MGN Ltd. [2000] 1 WLR 515, at 527

Dr. Corby, as a doctor, owes a duty of confidentiality to their patients, but she also has a wider duty to protect and promote the health of patients and the public. The Lancet World report stated that doctors are obliged to inform the police when they treat patient whom they suspect to have been involved in a serious knife crime. In this case, Dr Corby must inform the police as Alex is a patient with a serious stab wound. According to Jon, there were other such incidents in the concerned area, including 2 stabbings incidents. Alex’s case seems to be a result f a serious knife crime. The importance of disclosure is that it would help the police deal with any immediate threat to public safety. The General Medical Council makes such reporting obligatory. Dr Corby is responsible for treating Alex. As such, she should make sure that the police are contacted. Dr. Corby can delegate it to Jon to do this task. Personal information of Alex such as his name and address should not be disclosed in the initial contact with the police. They need to report only the facts of the injury. AS a serious crime is not defined by the criminality but the harm it represents. In this case, given that there have been serious knife crimes, it constitutes a threat of harm of harm to public safety. Information the police of the knife crime breaches doctor-patient confidentiality. It is subject to rare exceptions of compelling interest to protect public health. In this case the knife crime constitutes a rare exception as it is against public health. Dr Corby must inform Alex that a disclosure will be made to the police. It must be noted that while determining whether or not public interest in disclosing Alex’s information outweighs Alex and public’s interest in keeping confidentiality, potential



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17. General Medical Council, ‘Disclosing patients' personal information: a framework’ accessed 3 February 2021 ; Claudia Carr, Unlocking Medical Law and Ethics (Taylor & Francis 2013) 154.
18. Lancet World Report, ‘UK doctors begin reporting gun and knife crime’ Vol 374 December 19/26, 2009 accessed on 3 February 2021 .
19. Ibid.
20. General Medical Council ‘Confidentiality: reporting gunshot and knife wounds’ accessed on 3 February 2021
21. Lancet World Report, ‘UK doctors begin reporting gun and knife crime’ Vol 374 December 19/26, 2009 accessed on 3 February 2021
22. Ibid.
23. Lancet World Report, ‘UK doctors begin reporting gun and knife crime’ Vol 374 December 19/26, 2009 accessed on 3 February 2021
benefits to the society must be considered. In this case, disclosing outweighs confidentiality.

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24. General Medical Council ‘Confidentiality: reporting gunshot and knife wounds’ accessed on 3 February 2021 .

Cases

Ashworth Security Hospital v MGN Ltd. [2000] 1 WLR 515 Hunter v Mann [1974] 2 WLR 742.

Legislation

Serious Crime Act 2007

Bibliography Books

Carr C, Unlocking Medical Law and Ethics (Taylor & Francis 2013) Dimond B, Legal Aspects of Patient Confidentiality (Mark Allen Group 2014) Herring J, Medical Law and Ethics (Oxford University Press 2020) 266

Others

Health and Care Professions Council, ‘Standards of conduct, performance and ethics’ accessed 2 February 2020

. General Medical Council ‘Confidentiality: reporting gunshot and knife wounds’ accessed on 3 February 2021

General Medical Council, ‘Disclosing patients' personal information: a framework’ accessed 3 February 2021

. General Medical Council, ‘Disclosures for the protection of patients and others’ accessed 3 February 2021

. General Medical Council, ‘Disclosing patients' personal information: a framework’ accessed 3 February 2021

. General Medical Council, ‘Disclosing patients' personal information: a framework’ accessed 3 February 2021

Reports

Lancet World Report, ‘UK doctors begin reporting gun and knife crime’ Vol 374 December 19/26, 2009 accessed on 3 February 2021

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