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How can you meet your obligations around confidentiality?

28 July 2020

Dr Joe Ingham, dentolegal consultant at Dental Protection, looks at why confidentiality is vital in dentistry

Confidentiality is the cornerstone of a successful dentist-patient relationship. Indeed the word “confidence” derives from the Latin con “with” and fidere “to trust”. It is clear that dentists who break a patient’s confidence undermine trust in the dental profession and they will be dealt with very seriously. Patients are entitled to expect that information about them will be held in confidence and the information they disclose in the context of a professional relationship, will be protected and respected.

Survival tips

  • Remember that confidential information includes a patient’s name and address.
  • A breach of confidentiality may be justifiable when a dentist’s duty to society overrides their duty to the individual patient and it is deemed to be in the public interest. For example, when there is a threat of serious harm to the patient or others. Before breaching confidentiality, always consider obtaining consent and consider taking advice from colleagues.
  • Disclosure of patient information may be required by law, for example to comply with infectious disease regulations. The courts can also require dentists to disclose information, although it would be a good idea to contact Dental Protection if you find yourself presented with a court order.
  • Patient information remains confidential even after death. Consider the purpose behind any request for disclosure and the possible effect on the reputation of the deceased.
  • Patient privacy should be maintained at all times; accidental disclosure of confidential information should not occur. High-risk areas where breaches can occur are the clinic or treatment room, reception area, waiting room, lifts, a nearby restaurant or area where staff may gather.
  • Patient information should be held securely and in compliance with data protection legislation.

Scenario 1

Dentist A is working in the practice and has just completed the afternoon session having seen many patients that day. Just as Dentist A is about to leave the practice, a police officer comes to the reception area and enquires about a potential patient who may have attended the previous day and describes the appearance and age of the patient. The police officer asks for confirmation that the patient attended and gave a time of the potential appointment. The police advised that the person was a known suspect and they wanted to corroborate an alibi given by the patient in connection with the investigation of a crime. There was no suggestion of a threat to public safety.

Dentist A is unsure whether he can provide the information requested by the police. The dentist speaks to a colleague and they discuss whether in this case, where there has been a request for information to confirm attendance of a patient and where there is no obvious risk to the general public, he would be able to justify breaching the confidence of the patient concerned even if a crime had been committed.

In this scenario there was no court order and as they were not aware of consent from the patient to disclose the confidential information, it was considered likely that disclosure would be unreasonable. It was agreed that they would seek further advice from Dental Protection and explained that whilst they did not wish to impede the police enquiries, they had an obligation to respect the patients’ confidentiality. Ultimately the police were asked to obtain the patient’s written consent to agree to the disclosure of the requested information.

Scenario 2

Dentist A was contacted on the phone by the police at the practice and was advised that there had been an attempted child abduction in the doorway leading to the waiting room of the practice. The police requested details of all the patients who had visited the practice that morning.

Dentist A considered that the request was regarding a serious nature about a patient and in relation to a serious crime. In this scenario the practitioner agreed to the request from the police to release the details of the patients who had attended that morning on the basis that the serious nature of the incident merited the breach in confidentiality.