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Private and confidential?

Private and confidential?: Handling personal information in the social and health services

Chris Clark
Janice McGhee
Copyright Date: 2008
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  • Book Info
    Private and confidential?
    Book Description:

    Handling personal and often sensitive information is central to daily practice in social and health services. However, the increasing emphasis on multi-disciplinary and inter-agency working required for effective, joined-up services presents new challenges and dilemmas in preserving citizens' rights to privacy. This book examines key philosophical, ethical and legal issues in the area of privacy and confidentiality and explores their implications for policy and practice. ,Offering a range of analytical frameworks the book focuses on different practice areas, including health and social care, children's services and criminal justice. The contributors from disciplines including law, philosophy, anthropology and the personal service professions bring their direct personal experience of working to create new systems and practices in a turbulent policy environment. The book provides a synoptic multi-disciplinary view of this increasingly challenging area where technological development, civil liberties, surveillance, health and welfare become inexorably intertwined. The book will be of key interest to professionals, managers, policy makers and academics in the health and personal social services. Students of social work, probation, medicine, nursing and professions allied to medicine will find a common multidisciplinary framework for their respective professional concerns to protect the interests and promote the wellbeing of clients, their families and the wider community.

    eISBN: 978-1-84742-356-6
    Subjects: Health Sciences, Sociology

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Table of Contents
    (pp. iii-iv)
  3. Notes on contributors
    (pp. v-viii)
  4. Introduction
    (pp. 1-14)
    Janice McGhee and Chris Clark

    Privacy and confidentiality are fundamental concepts in law, philosophy, anthropology, political theory, medicine, health and social welfare. They are also culture-specific, complex and problematic concepts in both theory and professional practice. Confidentiality is regarded as a central tenet of practice for medical, health, social work and other professionals in the health and personal social services. These professionals handle personal and often sensitive information obtained from the citizen as client, patient or service user. They do so with the primary intention of benefiting the individual’s health and social welfare, and sometimes also with the aim of realising benefits for the wider...

  5. Part One: Professional confidentiality revisited

    • ONE Personal information and the professional relationship: issues of trust, privacy and welfare
      (pp. 17-34)
      Cynthia Bisman

      Philosophical, historical and political perspectives inform this chapter’s exploration of the meaning and value of privacy in professional relationships. Rights of privacy allow for individual choice in deciding whether to share personal information with others. This provides individuals some control over the flow of information about themselves and confers on privacy a particular authority in protecting individual identity and sense of self. Grounding privacy and professional relationships within an ethical and moral framework clarifies how they contribute to social welfare and the social good. Virtue ethics can inform an understanding of privacy as a personal right and a public interest...

    • TWO Confidentiality, trust and truthfulness in professional relationships
      (pp. 35-48)
      Chris Clark

      Professional codes of ethics standardly contain the expectation of confidentiality. The following plain and concise statements from the General Medical Council can well serve as a working definition of the principle as it applies in all the personal service professions (GMC, 2000):

      Doctors hold information about patients which is private and sensitive. This information must not be given to others unless the patient consents or you can justify the disclosure. (p 1)

      Patients have a right to expect that information about them will be held in confidence by their doctors. Confidentiality is central to trust between doctors and patients. Without...

    • THREE Confidentiality in practice: non-Western perspectives on privacy
      (pp. 49-62)
      Ian Harper

      After being trained in medicine I worked as a doctor in hospital medicine and general practice in the UK. Since 1990 I have both worked in Nepal as a medical practitioner and researched into the practices of medicine and public health as an anthropologist. I have been responsible for recording patient data onto notes, their storage in remote clinics, and their transfer as part of trials of tuberculosis (TB) treatments and their outcomes in remote parts of Nepal. I have talked to patients and their relatives about their medical diagnoses in situations where health is frequently understood in quite different...

    • FOUR Ethical practice in joined-up working
      (pp. 63-82)
      Ian E. Thompson

      In this chapter the approach will be to work from the actual needs of practice to agreed ethical policy and procedures. Here we seek to follow Aristotle’s advice to proceed a posteriori rather than a priori in our exploration of the issues involved in handling personal information. Aristotle argued that ethics is a practical science, intimately connected with law and politics, and that these form part of the same continuum – embracing in one frame the personal, communal and sociopolitical aspects of our sharing of power and responsibility in any moral community. Aristotle’s approach is in a broad sense empirical and...

  6. Part Two: Balancing individual privacy with the right to information

    • FIVE The right to privacy and confidentiality for children: the law and current challenges
      (pp. 85-110)
      Lilian Edwards and Rowena Rodrigues

      How far should the law protect privacy? What balance should be struck between the individual’s right to privacy and the interests of society? Should the privacy of the family bow to the duty on the state to safeguard the interests of vulnerable children and adults within a family? Should parents have the right to know everything about their children, or do children too need rights to a private sphere?

      Questions like these have long been contested both in law and in society, and will recur throughout this book. They will not be solved in this brief chapter. Instead, we will...

    • SIX Public protection in practice: Multi-Agency Public Protection Arrangements (MAPPA)
      (pp. 111-128)
      Hazel Kemshall and Jason Wood

      The late 1990s saw the development of Multi-Agency Public Protection Arrangements (MAPPA) in England and Wales (with slightly later developments in Scotland). These arrangements were given legislative force in the 2000 Criminal Justice and Courts Services Act (sections 67 and 68), with police, probation (and prisons added by the 2003 Criminal Justice Act; CJA) as ‘responsible authorities’ tasked with risk assessing and managing offenders who meet the MAPPA criteria (Home Office, 2004). In order to carry out these duties, personal information on offenders is collected, stored and exchanged. MAPPA agencies are mindful that they must operate within the law, particularly...

    • SEVEN The right to information in practice: adoption records, confidentiality and secrecy
      (pp. 129-146)
      Gary Clapton

      This chapter concerns adoption and secrecy. It is about the people involved in adoptions. The chapter is designed to open up debate. The discussion draws from the author’s research (Clapton, 2003, 2006) and 10 years’ experience as an adoption counsellor, and also from discussions with the staff of Birthlink, an after-adoption service run by Scottishbased adoption agency Family Care.

      Reference is very often made to the ‘adoption triad’: the adopted person, the adoptive parents and the birth parents. All too often the fourth party directly involved in adoption – the social worker – is omitted. Here the importance of this fourth person...

  7. Part Three: Working together

    • EIGHT Confidentiality and information sharing in child protection
      (pp. 149-168)
      Janice McGhee

      The direction of UK and Scottish government policy towards the promotion of ‘joint working’ between agencies and professionals and the advent of multidisciplinary teams has made information sharing more central to effective practice and service delivery. Tensions can arise, however, between differing professional guidelines (Crichton, 2001). In child welfare the importance of interagency cooperation and information sharing to protect children at risk of abuse and neglect is longstanding and is reflected in government guidance and interagency protocols and procedure including multiagency case conferences (Scottish Office, 1998; Scottish Executive, 2003; DfES, 2006a). The UK child protection system developed from the mid-1970s...

    • NINE Working with children and young people: privacy and identity
      (pp. 169-190)
      Peter Ashe

      Some years ago, we were waiting in an airport arrivals area for our teenage son to return from the other side of the world. After a lengthy and fruitless wait alongside the baggage carousel, we decided to ask where he might be. At the domestic airline desk we were solemnly informed that ‘under the terms of the [1998] Data Protection Act, such private information could not be released’. Other than suggest that wecouldask the police to force him to tell us, the official seemed unable to do anything other than repeat this simple mantra. Luckily, the callhandler at...

    • TEN Working with adults with incapacity
      (pp. 191-208)
      Susan Hunter and Lisa Curtice

      Adults with incapacity are people who lack capacity to take specific or all decisions. They include people with dementia, people with learning disabilities, people with severe acquired brain injury, people with severe mental illness and people with severe communication problems due to a physical condition, such as stroke. This chapter considers the issues as they may affect adults with learning disabilities.

      For at least a decade, the direction of travel in policy and practice in the support of people with learning disabilities, underpinned by a rights-based approach, has been towards more individualised support with the person themselves having a greater...

    • ELEVEN Working together? Sharing personal information in health and social care services
      (pp. 209-230)
      Val Baker

      In the 4th century BC Hippocrates made the following statement about the confidentiality of patient information:

      Whatsoever things I see or hear concerning the life of men, in my attendance on the sick or even therefrom, which ought not to be noised abroad, I will keep silence thereon, counting such things to be as sacred secrets. (Kennedy and Grubb, 1994, p 637)

      If that were to be written today it might say:

      Whatever I see or hear in my attendance on the sick or even apart therefrom will be divulged to physicians, nurses, aides, anaesthetists, dieticians, physical therapists, admitting clerks,...

  8. Conclusion
    (pp. 231-240)
    Chris Clark and Janice McGhee

    The contributions to this volume demonstrate that expectations and standards defining the professional duty of confidentiality are now in an unprecedented state of flux. In an important sense there is nothing new about the obligation to safeguard individuals’ privacy and therefore protect their communications with a promise of nondisclosure: it has been a key feature of the professional relationship at least since Hippocrates. But when we set this continuing obligation against the contemporary context of professional practice we see that the traditional promise, although ostensibly as highly valued as ever, is becoming increasingly problematic to interpret and to apply. What,...

  9. Index
    (pp. 241-248)