One morning there was a loud commotion outside the surgery and a mother rushed into the waiting room with her three year old child who had been bitten on the leg by the patient's dog (one of the other patients later reported that she saw the child kick the dog, which then provoked the attack).
The GP immediately took the child to the treatment room to deal with the dog bite. Meanwhile, the elderly female patient slipped out of the surgery, quickly untied her dog and went home. The mother was furious. She wanted to report the dog to the local Council to have it destroyed and demanded the GP provide the name and address of the patient that owned the dog. The GP was not sure what to do and rang MDA National for advice.
Medico-legal issues
A medical practitioner has both a legal and ethical duty to preserve patient confidentiality. Medical practitioners can provide information to a third party without it constituting a breach of confidentiality in any of the following situations:
- the patient consents to the release of the information
- disclosure to another health professional to ensure appropriate medical care of the patient
- mandatory disclosure of information is required under law – for example, a subpoena or other court order; statutory requirements in regard to child abuse and infectious diseases
- where there's an overriding duty in the "public interest" to disclose information – for example, a patient who threatens harm against another person; or a patient who refuses to stop driving despite medical advice to do so. These cases involve situations where there is a serious threat to an individual's life, health or safety; or a serious threat to public health or safety.
In this case, none of the exceptions applied. In particular, the elderly patient did not want her contact details disclosed to the child's mother and there did not appear to be a "public interest" in doing so.
MDA National's Medico-legal Adviser informed the GP that a duty of confidentiality was owed to the elderly patient (and her dog) and that the GP should politely inform the mother that it was not legally possible to give her this information.
The GP did not hear anything further about the matter – and the elderly patient continued to attend the practice each week, but she left her dog at home during the visits.
