Group 4 Project Medicine and the Law

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Group 4 Project: Medicine and the Law

Main topic

The relaxation of the rules on confidentiality- Is it justifiable?or Should the Doctor Tell?

???

Children

Capacity

Mental Health Act 2007

Age of Legal Capacity (Scotland) Act 1991

s.2 (4)

s.1(a)

Abortions

R. (on applidcation of Axon) v. Secretary of Health 2006

Moth sought review of 2004 document, wanted disclosure

Women under 16 can seek an abortion without parental consent

If they meet Fraser guidelines

Contraception

2004 Department of Health document that gives guidance on giving advice and treatment to under 16s

Gillick v West Norfol Area Health Authority (1985)

Lord Fraser Guidelines

Child abuse

Confidence can be breached if there is evidence patient is abusing a child

Subtopic

M and N (Minors), Re

Disclosure to sexual partner

What if doesn't disclose and partner gets infected?

Would Tarasoff decision be replicated here? Brazier and Cave suggest it would not.

American Case - Tarasoff v Regents Uni of California: Found liable in negligence for not breaching patient's confidentiality to warn individual of risk.

Did the Dr. have a duty to tell them?

Do they have a right of action?

Position if person at risk is also a patient of the Dr. (Special relationship)

Australia (PD v Harvey and Chen) Disclosing as last resort

US and Canada- Statutory duty to inform person at risk

No definitive legal decison in the UK - just about balancing rights.

General Medical Council and Institute of Medical Ethics (Guidance)

Disclosure of infected health worker( X v Y and H v Associated Newspapers Limited)

Heath Authority Duty to Report (Aids Control Act 1987)

Confidentiality and the deceased

Genetics Commission

Public Rights to medical history of the dead

Disclosing the status of deceased persons

Legal Issues

Ethical

Whether General Duty continues after death is unclear

Department of Health (ethical basis)

Guidance from General Medical Council

Lewis v Sec State for health and Bluck cases

Exceptions to Confidence

Statutory

Public Interest

Press Freedom

Medical Research

Preventing or detecting crime

Family (Child Protection)

HIV

Consent

Arguments in favour/against confidentiality?

Against

May protect others in society

May be better for the protection of the patient

favour

Builds up trust

Aids an effective health care system

Best medical care can be given because patient will be honest

Duty of Confidence

Hippocratic Oath

Not a single statute or common law body of laws governing confidentiality

Patients may be unwilling to disclose

Common Law Duty