Privacy, Confidence and Horizontal Effect: “Hello” Trouble

Morgan, Jonathan

doi:10.1017/s0008197303006378

Cited by 24 publications

(2 citation statements)

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“…Definitions of the concept of privacy have proved challenging [ 27 , p. 445]. Moore observes that the common element in all definitions of privacy is the exercise of control over one’s personal information [ 28 , p. 216].…”

Section: Main Textmentioning

confidence: 99%

Undisclosed probing into decision-making capacity: a dilemma in secondary care

Talukdar

2021

BMC Med Ethics

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Background The assessment of patients’ decision-making capacity is ubiquitous in contemporary healthcare. This paper examines the ethics of undisclosed probing of capacity by psychiatrists. The discussion will refer to the law in England and Wales, though the highlighted issues are likely to be relevant in similar jurisdictions. Main text Decision-making capacity is a private attribute, and patients may not necessarily be aware that one of their personal abilities is being explored. Routine exploration of capacity has not historically been a part of psychiatric examination, but it is now difficult to avoid during psychiatric interview.Ethical practice and shared decision-making require patients to be aware that their decision-making may be evaluated by the doctor at some point, and the potential implications of an objective professional conclusion of incapacity. Case law directs that patients should be informed about any assessment of their decision-making ability, though the extent to which this has translated into practice is unclear. However, explanation about the assessment may cause a patient to react negatively, which may impede therapeutic engagement and constitute an ethical dilemma. It is argued that in the absence of systemic measures, professionals should retain the discretion to decide whether a particular patient should be informed about the impending probe into their decision-making ability, or not. In the latter instance, concealment of information about the assessment or its purpose should be subject to the caveats and safeguards associated with any recourse to therapeutic exception. Conclusion The necessity to mandatorily inform patients about assessment of their capacity introduces a novel ethical dilemma for psychiatrists. The negotiation of this dilemma should not be the prerogative of the clinician, and requires systemic initiatives to ensure universal awareness of patients about the possibility of their capacity being assessed during their journeys through healthcare systems.

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Section: Main Textmentioning

confidence: 99%

Undisclosed probing into decision-making capacity: a dilemma in secondary care

Talukdar

2021

BMC Med Ethics

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“…Both Wainwright and Kaye demonstrate that U.K. courts are not blind to the need for privacy protections, yet they also highlight the fact that the courts are unwilling to create a new tort for that purpose. Commentators have suggested, though, that existing remedies are inadequate to protect against intrusions upon personal privacy . Yet the progression of breach of confidence in English courts has marked a step forward.…”

Section: The Right Of Privacy For Public Figures In the United Kingdommentioning

confidence: 99%