“Turning a blind eye”

We as students tend to turn a blind eye toward the right of the patient’s confidentiality. We speak to our friends, family members and our clinicians about our patient but in actual fact, we are breaking that trust that was formed between us and our patients. We tend to “turn a blind eye” unintentionally, we think we are asking for advice or just wanting to vent about the day but we are disclosing our patient’s diagnosis, information and we also speak about how the session went with the patient without the patient’s consent. The picture by Orange culture portrays such a beautiful representation of “turning a blind eye”, the photographer uses two people where one covers the eyes of the other, this can have a deeper meaning it can be viewed as the therapist and the patient where the therapist ignorantly ignores the right of confidentiality of the patient by disclosing personal information to their colleagues, friends and family members.

Confidentiality is an ethical principle, it is defined as “..Respecting other people’s secrets and maintaining the security of information elicited from individuals in the privilege circumstances of a professional relationship” (Lees & Goldbold, 2012). Anonymised data mean the patient cannot be identified by any information where the name, address and postal address is removed together with any information that may be linked to the patient. This is data where you only know what is wrong with the patient and it does not involve any personal information of the patient (HPCSA, 2008). These two terms may often be confused.

Confidentiality is different in terms of speaking to the doctor or to another professional worker because it is in regard to the patient and we are treating the patient holistically, however it is being broken when we speak to individuals that are not a part of the interdisciplinary team. The National health Act (Act 61 of 2003) provides that this information must not be given to others unless the patient consents or the health practitioner can justify disclosure (HPCSA, 2008). It is assumed that information will be disclosed within the healthcare team, however the patient has the right to request that certain information be withheld from the team.

According to evidence students’ seek guidance from their colleagues and other health professionals, rather than taking the law into consideration, it also investigated students point of view on confidentiality from a multidisciplinary point of view, evidence discovered that students would violate the law of confidentiality to other member of the team because the outcome would be positive for the patient (Lees & Goldbold, 2012). Some patients’ understand that their information needs to be discussed with other members of the multidisciplinary team for a holistic management approach or even for student learning purposes, revealing patient information to the other healthcare workers only requires a specific amount of relevant information to be disclosed about the patient (Blightman, Griffiths, & Danbury, 2013).

We as students face ethical dilemmas at times, we often do not know to whom we may or may not give information to, we do not get taught in detail about the extent of confidentiality (Nortjé & de Jongh, 2016).

Clinical example:

I am guilty of violating the confidentiality of my patients’ information. I speak to my colleagues and friends, I disclose information, not personal information but I do speak about my patients- I do it subconsciously. I do not think of the ethical principle attached to it. We as students sometimes think we are just trying to find a better perspective on our patient and we also complain about our patients, then we also elaborate on the patient’s condition and why it is so difficult to treat them but we are breaking an ethical code. This year’s clinical experience has been very challenging, often I would speak to my friends and my family about my patients and I would speak about how difficult they were in a condition aspect or I would speak about them in an overall aspect- about conditions, emotional status, and personalities. I reveal the personal details but I am disclosing information I am not allowed to disclose.

Clinical practice is demanding on your mental and physical health and sometimes you just need to speak to someone about it. We as students, even our clinicians and lecturers do the same thing we break the ethical principle of confidentiality but not purposefully. Knowing the difference between anonymous and confidentiality it helps a lot regarding disclosure of information. If this situation had to arise again I would most likely handle it with caution, I would think before disclosing information and sometimes we as student we need to disclose information to help us gain perspective about the patient or we might need a second opinion from our colleagues. I would give only the necessary information about my patient and not disclose a whole patient history but only give the listener the basics to help me with future practice.

References

Blightman, K., Griffiths, S. E., & Danbury, D. (2013). Education in Anaesthesia Critical Care & Pain. Patient confidentiality: when can a breach be justified?, 52–56.

HPCSA. (2008, MAY). Retrieved from HPCSA: GUIDELINES FOR GOOD PRACTICE IN THE HEALTH CARE: http://www.hpcsa.co.za

Lees, A. B., & Goldbold, R. (2012). New Zealand Journal of Physiotherapy. To tell or not to tell? Physiotherapy students’responses to breaking patient confidentiality, 59-63.

Nortjé, N., & de Jongh, J. (2016). South African Journal. Client confidentiality: Perspectives of students in a healthcare training programme, 31-34.