Abstract
Maintaining privacy of personal health information is a key ethical feature of the relationship between patients and health care practitioners. We will explain why confidentiality is important, why sharing of information is important to excellent healthcare and will focus on the duties and obligations of physicians. In pediatrics, health care information "belongs" to the child patient, but in the very young, authority over this information is exercised by the parent/guardian. Over time, the child will exercise more and more control over their health information. We stress that the physician is only one member of the healthcare team, and will also mention the duties and obligations of those many other healthcare professionals who are involved with the family. We will describe situations when confidentiality must be breached in the interest of the child patient.
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References
Allen E-CF, Arroll B (2015) Physician self-disclosure in primary care: a mixed methods study of GPs’ attitudes, skills, and behaviour. Br J Gen Pract 65(683):e601–e608. https://doi.org/10.3399/bjgp15X686521
American Academy of Pediatrics, Committee on hospital care, Institute for Family-Centered Care (2003) Policy statement: organizational principles to guide and define the child health care system and/or improve the health of all children: family-centered care and the pediatrician’s role. Pediatrics 112(3):691–696
American Medical Association (2008) AMA code of medical ethics: opinion 5.051 – confidentiality of medical information post-mortem. American Medical Association, Chicago, p 165
American Medical Association (2015) AMA code of medical ethics: opinion 9.124 – professionalism in the use of social media. AMA J Ethics 17(5):432–434
Asnes AG, Leventhal JM (2010) Managing child abuse. Pediatr Rev 31(2):47. https://doi.org/10.1542/pir.31-2-47
B. (R.) v. Children’s Aid Society of Metropolitan Toronto (1995) 1 SCR 315. p. 432 per Iacobucci F, Major JC. https://scc-csc.lexum.com/scc-csc/scc-csc/en/item/1220/index.do. Accessed 6 Sep 2018
Baker RC, Klein M, Samaan Z, Brinkman W (2007) Exam room presentations and teaching in outpatient pediatrics: effects on visit duration and parent, attending physician, and resident perceptions. Ambul Pediatr 7:354–359
Benward J (2012) Identity development in the donor-conceived. In: Guichon JR, Mitchell I, Giroux M (eds) The right to know one’s origins: assisted human reproduction and the best interests of children. ASP, Brussels
Bluebond-Langner M (1980) The private worlds of dying children. Princeton University Press, Princeton
Bok S (1989) Secrets: on the ethics of concealment and revelation. Vintage Books, New York
Bok S (1999) Lying: moral choice in public and private life. Vintage Books, New York
Bozzo A (2018) A challenge to unqualified medical confidentiality. J Med Ethics 44:248–252. https://doi.org/10.1136/medethics-2017-104359
Canadian Medical Association (2018) Privacy and confidentiality. https://www.cma.ca/En/Pages/privacy-confidentiality.aspx. Accessed 1 Aug 2018
Chadwick R (2016) Genetic exceptionalism. In: Kumar D, Chadwick R (eds) Genomics and society genetic. Elsevier, London. https://doi.org/10.1016/C2013-0-12992-3
Chadwick P (2018) How many people had their data harvested by Cambridge Analytica? The Guardian Mon 16 Apr 2018 07.00 BST https://www.theguardian.com/commentisfree/2018/apr/16/how-many-people-data-cambridge-analytica-facebook. Accessed 24 July 2018
Child, Youth and Family Enhancement Act, RSA 2000, C-12 (2017) Alberta Queen’s Printer, Edmonton. http://www.qp.alberta.ca/documents/Acts/c12.pdf Accessed 31 July 2018
Chretien KC, Kind T (2013) Social media and clinical care: ethical, professional, and social implications. Circulation 127(13):1413–1421. https://doi.org/10.1161/CIRCULATIONAHA.112.128017
Corday B (2012) Does the right to know matter? In: Guichon JR, Mitchell I, Giroux M (eds) The right to know one’s origins: assisted human reproduction and the best interests of children. ASP, Brussels
Crawford-Jakubiak JE, Alderman EM, Leventhal JM, AAP Committee on Child Abuse and Neglect, AAP Committee on Adolescence (2017) Care of the adolescent after an acute sexual assault. Pediatrics 139(3):e20164243. https://doi.org/10.1542/peds.2016-4243
Davidson JE (2013) Family presence on rounds in neonatal, pediatric, and adult intensive care units. Ann Am Thorac Soc 10(2):152–156. https://doi.org/10.1513/AnnalsATS.201301-006PS
Denecke K, Bamidis P, Bond C, Gabarron E, Househ M, Lau AYS, Mayer MA, Merolli M, Hansen M (2015) Ethical issues of social media usage in healthcare. Yearb Med Inform 10(1):137–147
Dwoskin E, Romm T, Timberg C (2018) Facebook removes hundreds of pages controlled by the Russian organisation that meddled in the US election. The Washington Post 10:38. Wednesday 4 April 2018. https://www.independent.co.uk/news/world/americas/facebook-pages-russia-putin-kremlin-us-election-meddling-a8287621.html. Accessed 24 July 2018
Grant K (2014) Ontario hospital cannot force chemo on 11-year-old native girl, court rules. The Globe and Mail November 14, 2018. https://www.theglobeandmail.com/life/health-and-fitness/health/cancer-patient-has-right-to-use-aboriginal-healing-instead-of-chemo-judge-rules/article21587859/. Accessed 24 July 2018
Guichon JR (2012) A comparison of the law in Canada related to the disclosure of information regarding the biological parents of adoptees and the donor-conceived. In: Guichon JR, Mitchell I, Giroux M (eds) The right to know one’s origins: assisted human reproduction and the best interests of children. ASP, Brussels
Hallett M (2015) Tourette syndrome: update. Brain Dev 37(7):651–655. https://doi.org/10.1016/j.braindev.2014.11.005
Hammond CL, Willoughby JM, Parker MJ (2018) Genomics for paediatricians: promises and pitfalls. Arch Dis Child. ePub. https://doi.org/10.1136/archdischild-2017-314558
Heilferty CM (2011) Ethical considerations in the study of online illness narratives: a qualitative review. J Adv Nurs 67(5):945–953. https://doi.org/10.1111/j.1365-2648.2010.05563.x
Herbert PB (2002) The duty to warn: a reconsideration and critique. J Am Acad Psychiatry Law 30:417–724
Hippocrates. Oath of Hippocrates (1995) In: Reich WT (ed) Encyclopedia of bioethics 2nd ed, volume 5, appendix, 2632. Simon & Schuster Macmillan, New York
Johnston BL (2018) Professional competence: the HIV infected physician. Royal College of Physicians and Surgeons of Canada. http://www.royalcollege.ca/rcsite/bioethics/cases/section-3/professional-competence-hiv-infected-physician-e. Accessed 1 Aug 2018
Jonsen AR, Cooke M, Koenig BA (1986) AIDS and ethics. Issue Sci Technol 2(2):56–65
Kushnir VA, Barad DH, Albertini DF, Darmon SK, Gleicher N (2017) Systematic review of worldwide trends in assisted reproductive technology 2004–2013. Reprod Biol Endocrinol 15:6. https://doi.org/10.1186/s12958-016-0225-2
Landry MA, Lafrenaye S, Roy MC, Cyr C (2007) A randomized, controlled trial of bedside versus conference-room case presentation in a pediatric intensive care unit. Pediatrics 120(2):275–280. https://doi.org/10.1542/peds.2007-0107
Macklin R (1998) Ethical relativism in a multicultural society. Kennedy Inst Ethics J 8(1):1–22
Markel H (2004) “I swear by Apollo”—on taking the hippocratic oath. N Engl J Med 350(12):2026–2029. https://doi.org/10.1056/NEJMp048092
McKlindon D, Jacobson JA, Nathanson P et al (2016) Ethics rounds: in the eye of a social media storm. Pediatrics 138(3):e20161398. https://doi.org/10.1542/peds.2016-1398
Meert KL, Eggly S, Pollack M et al (2007) Parents’ perspectives regarding a physician-parent conference after their child’s death in the pediatric intensive care unit. J Pediatr 151(1):50–55. https://doi.org/10.1016/j.jpeds.2007.01.050
Narang SK, Paul SR, Committee on Medical Liability and Risk Management (2017) Expert witness participation in civil and criminal proceedings. Pediatrics 139(3):e20164122. https://doi.org/10.1542/peds.2016-4122
O’Farrell M (2017) I AM I AM I AM: seventeen brushes with death. Penguin Random House, New York
Patel N, Ballantyne A, Bowker G, Weightman J, Weightman S, Helping Us Grow Group (HUGG) (2017) Family integrated care: changing the culture in the neonatal unit. Arch Dis Child 103(5):415–419. https://doi.org/10.1136/archdischild-2017-313282
PatientsLikeMe (2018) GodsMiracleBaby https://www.patientslikeme.com/members/101148. Accessed 5 May 2018
Rosenberg AR, Starks H, Unguru Y, Feudtner C, Diekema D (2017) Truth telling in the setting of cultural differences and incurable pediatric illness. A review. JAMA Pediatr 171(11):1113–1119. https://doi.org/10.1001/jamapediatrics.2017.2568
Sacks O (1962) A surgeon’s life. The New Yorker March 16, 1992 Issue. https://www.newyorker.com/magazine/1992/03/16/a-surgeons-life. Accessed 10 Aug 2018
Shaikh T (2007) Sally Clark, mother wrongly convicted of killing her sons, found dead at home. https://www.theguardian.com/society/2007/mar/17/childrensservices.uknews. Accessed 10 Aug 2018
Siegler M (1982) Confidentiality in medicine – a decrepit concept. N Engl J Med 307:1518–1521. https://doi.org/10.1056/NEJM198212093072411
Sisk BA, Bluebond-Langner M, Wiener L et al (2016) Prognostic disclosures to children: a historical perspective. Pediatrics 138(3):e20161278
Sorosky AD, Baran A, Pannor R (1989) The adoption triangle. Corona Publishing, San Antonio. quoted in Kahan M (2006) “Put up” on platforms: a history of 20th century adoption policy in the United States. Sociol Soc Welf 33(3):51–71
Statista (2018) Most popular social networks worldwide as of July 2018, ranked by number of active users (in millions). https://www.statista.com/statistics/272014/global-social-networks-ranked-by-number-of-users/. Accessed 24 July 2018
Sunderam S, Kissin DM, Crawford SB, Folger SG, Boulet SL, Warner L, Barfield WD (2018) Assisted reproductive technology surveillance—United States, 2015. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report Surveillance Summaries 67(3):1–28
Tallandini MA, Zanchettin L, Gronchi G, Morsan V (2016) Parental disclosure of assisted reproductive technology (ART) conception to their children: a systematic and meta-analytic review. Hum Reprod 31(6):1275–1287. https://doi.org/10.1093/humrep/dew068
Vigod SM, Bell CM, Bohen JMA (2003) Privacy of patients’ information in hospital lifts: observational study. BMJ 327(7422):1024–1025. https://doi.org/10.1136/bmj.327.7422.1024
Wang-Cheng RM, Barnas GP, Sigmann P, Riendi PA, Young MJ (1989) Bedside case presentations: why patients like them, but learners don’t. J Gen Intern Med 4(4):284–287
Watkins SJ (2000) Conviction by mathematical error? Doctors and lawyers should get probability theory right. BMJ 320(7226):2–3
Williams N (2012) Everyone is here for a reason. In: Guichon JR, Mitchell I, Giroux M (eds) The right to know one’s origins: assisted human reproduction and the best interests of children. ASP, Brussels
Yu Y, Ganesh A (2014) Calgary surgeon and educator retires, leaving generation of inspired medical students. http://calgaryherald.com/health/calgary-surgeon-and-educator-retires-leaving-generation-of-inspired-medical-students. Accessed 10 Aug 2018
Zwarensteyn J (2018) Why a mom shared the heartbreaking photo of her 5-Year-Old daughter’s last moments alive. https://www.yourtango.com/2018315143/how-zoey-daggett-die-why-mom-shared-photo-daughter-dying-brain-tumor. Accessed 24 July 2018
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Mitchell, I., Guichon, J.R. (2019). What Goes in the Chart and Who Can See It?. In: Ethics in Pediatrics. Springer, Cham. https://doi.org/10.1007/978-3-030-22617-6_5
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