Confidentiality and forensic disclosure in the primary healthcare setting

The relationship between the patient and the clinician is built on trust, and without it the effectiveness of any clinician is severely limited. In practice, doctors and nurses depend on their professional bodies for guidance [in the UK, these include the General Medical Council (GMC), the Nursing and Midwifery Council and the British Medical Association]. There are some exceptions to the primacy of confidentiality. This chapter explores when it may be morally and ethically right to breach this trust and where a legal requirement to keep or breach confidentially is ethically problematic. Computerisation of health data, which means that it may be accessed from multiple sites and by multiple individuals, has an impact on how clinicians act to protect patients’ confidentiality. Confidential medical care is recognized in law as being in the public interest. The World Health Organization defines female genital mutilation (FGM) as procedures which intentionally alter or injure the female genitalia for non-medical reasons.