Part 2
Dr Rix is also concerned about Julie’s health, both as his patient and as Mrs Giggs’ sole carer. He is worried that Julie may be drinking to excess, suffering mental health problems or otherwise in need of medical care or treatment.
Dr Rix wants to assess and address Julie’s needs, possibly by arranging a carer’s needs assessment to avoid problems developing further. He thinks that would benefit both Julie and Mrs Giggs.
How might Dr Rix go about discussing his concerns with Julie?
- Can he tell Julie what Mrs Giggs has said about her drinking or her behaviour?
- Should he seek Mrs Giggs’ agreement to raise with Julie those indications of ill health that Mrs Giggs has shared in confidence?
- What if Mrs Giggs refuses to allow him to discuss with Julie anything she has shared in confidence?
Dr Rix should explain to Mrs Giggs that, while he wants to hear her concerns, he cannot guarantee that he will not tell Julie about the conversation. It might be necessary to share with Julie some of the information provided by Mrs Giggs, especially if it influences Dr Rix’s assessment or treatment of Julie.
The information Mrs Giggs provides might be important to Dr Rix’s understanding of Julie’s needs as his patient. However, he also needs to consider whether Julie would consider such discussions to be a breach of trust, even if Dr Rix does not disclose confidential information about Julie in the process (paragraph 66).
Dr Rix tells Mrs Giggs that he will abide by her refusal to allow him to contact social services, but that his concerns about Julie’s health compel him to follow that up. He has two competing concerns: his duty to Julie, who is his patient; and his duty to respect Mrs Giggs’ confidences, including as the source of information about Julie. He assures Mrs Giggs that, in approaching Julie, he will be as discreet and sensitive as possible about both the nature of his concerns and the source of his information. He says he will not mention the abuse, but that he cannot guarantee to keep from Mrs Giggs the source of concerns about Julie’s health.