Consent

The General Medical Council (GMC) have issued guidance on the ethical and legal duties of confidentiality and highlight that doctors have obligations to protect patients’ personal information from improper disclosure. The guidance goes on to say that disclosure of some information can be “an essential part of the provision of safe and effective care”.

The GMC also offer further advice in this document about informed consent in paragraph 115. OH Physicians “must be satisfied that the patient has sufficient information about the scope, purpose and likely consequences of the examination and disclosure and the fact that relevant information cannot be concealed or withheld”. It goes on to advise that any report created should be offered to be seen by the patient before it is sent unless they have indicated they do not wish to see it in advance. In practice, this is often done via written consent.

In paragraph 116, it states that, “if a patient refuses or withdraws consent, you may still disclose information if it can be justified in the public interest.”

The Faculty of Occupational Medicine (FOM) have also published ethical guidance on confidentiality and the principal of consent to expand on this further. It advises that, “if on seeing the report the individual feels that any of the content is incorrect or misleading, they may request that the report is amended. This request must be made in writing.” Also, “the…doctor is not obliged to amend the report if requested by the individual concerned. At this stage the individual has the right to withdraw consent for the report to be issued, ask for a statement setting out their views to be attached, agree to report being issued unchanged.”

If consent is withheld, then it is important that individuals understand implications of not divulging certain information. This can often mean that employers will manage employees in the absence of medical advice which could then be detrimental to them.

From this, actual and constructive knowledge of an employee’s medical condition and possible disability can have important implications also.