Learning Activity: Confidentiality and Truth-telling Post test


Team: Clinical Ethics in Emergency Medicine
Posted on August 20, 2015


Learning Activity: Confidentiality and Truth-telling Post test

Team: Clinical Ethics in Emergency Medicine

Date: This is not a timed event.


1) What are the possible legal consequences of disclosing confidential clinical information without the patient's permission?



Federal PIPEDA – mostly for organizations but also for individuals – fines and jail

Provincial – all provinces have privacy legislation – again mostly for organizations but fines and ?jail


Civil liability – docs have a duty of confidentiality – if they breach and harm results then they would be liable



2) Identify at least 2 core ethical principles that support the concept of physician-patient confidentiality


Respect for autonomy – people have right to control their personal information, we have a responsibility to them in that regard

Beneficence – in patients best interest to know information kept confidentiality – more likely to come and to disclose


[?get at history of confidentiality – Hippocratic Oath and Code of ethics -  maybe frame this in terms of ethical arguments rather than principles]


3) Name 4 clinical situations in which you are legally mandated to disclose what would otherwise be confidential clinical information, and identify who this information should be disclosed to.


Suspected child abuse/neglect – Child Protection authorities


Reportable diseases – Public Health


Reportable deaths – Medical examiner


Aviation/train safety – Aviation safety authority/minister of transport


Abuse of vulnerable person – mandated in some, permitted in all – varying definitions  (incapable or cognitively challenged)



4) Identify 3 clinical situations where the legal mandate to disclose clinical information varies significantly from province to province


Driver reporting – Most provinces mandated, Quebec and Alberta permitted, BC – if still driving after advised not to – to


Gunshot and stab wounds – vary from province to province


Elderly/persons in care/persons in LTC facility – vary from province to province



5) Describe at least one protocol or approach for breaking bad news/disclosing difficult information to patients and families



Setting (setting up the interview)

Perceptions (patient’s/family’s understanding so far)

Invitation (from patient to share the news)

Knowledge (provide the information and answer specific questions)

Empathy/Emotion (respond to the patient’s emotions)

Strategy and Summary