Confidence and conflicts of duty in surgery

Abstract

This paper offers an exploration of the right to confidentiality, considering the moral importance of private information. It is shown that the legitimate value that individuals derive from confidentiality stems from the public interest. It is re-assuring, therefore, that public interest arguments must be made to justify breaches of confidentiality. The General Medical Council's guidance gives very high importance to duties to maintain confidences, but also rightly acknowledges that, at times, there are more important duties that must be met. Nevertheless, this potential conflict of obligations may place the surgeon in difficult clinical situations, and examples of these are described, together with suggestions for resolution. Legal reviewsThis is another paper in a series of reviews dealing with legal aspects of surgical practice. We have asked several distinguished authors, expert in their field, to contribute to this series. Our aim is to provide up-to-date guidance for surgeons in potentially difficult areas of their practice and academic work, whilst at the same time re-affirming the legal boundaries within which they work.

How do healthcare professionals manage ethical challenges regarding information in healthcare professional/patient clinical interactions? A review of concept- or argument-based articles and case analyses

“…For example, when family members cannot agree about whether to withdraw life support, or when family members or proxies hold contrary views regarding the withdrawal of treatment, nurses and intensivists are encouraged to negotiate these differences through active dialogue with the family members or proxies. [33,43,[51][52][53][54][55][56] In addition, when patients cannot make up their minds to consent to urgent lifesaving surgery, White and Lofwall [57] found that surgeons find it useful to encourage such patients to discuss their medical options (treatments) with close relatives, since this often leads to situations where patients eventually accept evidence-based treatment(s).…”