Siena College Taytay CHAPTER V: CONFIDENCIALITY AND

THE MANAGEMENT OF
College of Nursing
HEALTH CARE INFORMATION

 Confidentiality: A Principle with Qualifications

A patient’s basic right to expect that the information he gives a health care
practitioner held in confidence arrived at and defended using any of the four systematic
approaches: 1) utilitarian, 2) duty-oriented, 3)
virtue ethics, 4) divine command standpoint. The patient has the right to every consideration of
privacy concerning his own medical care program. Case
 In virtue ethics the practice of discussion, consultation, examination, and treatment
are confidential and should be conducted discreetly.
confidentiality has been a mainstay of Those not directly involved in his care must have the
health care practice and forms one of the permission of the patient to be present. The patient has
the right to expect that all communications and records
virtues that one would expect from a good pertaining to his care should be treated as confidential.
practitioner.
 Utilitarian: Not necessarily do the “Right Thing”, but to weigh the outcomes based
upon results that are good, or benefit the “What I may see or hear in the course of treatment or
largest amount of people. even outside of treatment in regard to the life of men,
which on no account must be noised abroad, I will keep
 Duty-oriented point of view: Personal to myself holding such things shameful to be spoken
about.” ----Hippocratic Oath
privacy is a
basic right with its foundations firmly based not only in long-standing codes but also
by law.
 Confidentiality is a critical principle and regardless of the specialty.
You may be found liable for any unauthorized breach of confidentiality that “offends the
sensibilities of an ordinary person”.
 Harm Principle- requires that the health care providers refrain from acts where the
individuals are particularly vulnerable to the risk.

 Confidentiality in Genetic Science:

The right to know overcomes the right to personal privacy and confidentiality in the
search for biomedical advances.

 Modern Health Care and Confidentiality

At least 75 individuals are legitimate access to the patient’s record by virtue that
they were involved in providing direct care or support services. Patient data are
used for administrative, payment, utilization review, teaching, and research. And
also by the following third parties:
insurance companies public health agencies
federal state
local government attorneys and law enforcement agencies
media
accreditation licensing and certification agencies

 Legal perspective to the medical record access

Instances like the following have legal requirements to report certain type of
information from the medical record: Child abuse
Drug abuse
Communicable disease
Injuries with guns and knives
Blood transfusion reactions poison and industrial accidents
Misadministration of radioactive materials

Edge R. and Groves J. R. (1999) Ethics of Health Care: A guide for Clinical Practice. C & E
Publishing Inc.
San Juan Metro Manila. 2nd Edition. pp. 70-80
 Siena College Taytay CHAPTER V: CONFIDENCIALITY AND
THE MANAGEMENT OF
College of Nursing
HEALTH CARE INFORMATION

 Legitimate interest
In general the patient’s record is confidential and limited to the patient, authorized
representative of the patient, attending physician, hospital staff who have legitimate
interests but there was also general guidelines accepted as to who have a legitimate
interest other than the mentioned and this was the ff :
Need is for the patient Professional Education Administrative functions
Research
Auditing functions Public health reporting Criminal Law requirements

Edge R. and Groves J. R. (1999) Ethics of Health Care: A guide for Clinical Practice. C & E
Publishing Inc.
San Juan Metro Manila. 2nd Edition. pp. 70-80