At the end of visiting time on the ward, the daughter of an elderly patient approached a medical student in the corridor and asked him how he felt her father was getting on.
The student had been on attachment to the ward for several weeks and had got to know the patient and his family, who visited daily. The student had spoken to the daughter before in the presence of the patient, and she had accompanied her father when the consultant had spoken to him about his illness.
Although the daughter was generally happy with the care her father was receiving, she did have a number of concerns that she wanted to discuss. She was aware that the consultant ward round had taken place that morning and she had spoken to her father although he could not remember everything the consultant said. The daughter asked the student to update her on her father's progress and to check the notes to see what had been recorded earlier.
The student had been present at the ward round but could not remember the entire plan so went to get the notes. When he returned he did not show the records to the daughter but explained what was written (as much of it was abbreviated anyway) and told her the plan for her father's care. In doing so, he allayed her concerns. She thanked him and left.
Later that day, the student was approached by the ward manager who had received a complaint from the patient's son raising concerns about a breach of his father's confidentiality. His sister, with whom he had a difficult relationship, had told him what the student had said. When he visited his father, it became apparent that the patient was not aware this conversation had taken place. The ward manager was also concerned that the student's conversation had been overheard by a patient who was sitting in the day room nearby.
The student contacted the MDU for advice.
The patient was not aware this conversation had taken place.
The MDU medico-legal adviser explained that although the daughter clearly had a good relationship with her father and generally accompanied him when his care was being discussed, the patient's consent was still required if any discussion
was going to take place about him. The patient should also have been given the opportunity to explain what information could and could not be shared, and with whom.
The medico-legal adviser suggested the student review the GMC's guidance on confidentiality, particularly paragraphs 64 to 66 which refer to sharing information with other people, such as the patient's relatives or friends. The student was also advised to review the trust's policy on confidentiality.
On the MDU's advice, the student wrote a statement for the ward manager, apologising and explaining exactly how the situation occurred. He was advised to reflect on his actions and how he would prevent it happening again.
This is a fictional case compiled from actual cases from the MDU's files.