Confidentiality guidance: The public interest

Disclosures in the public interest

1. 36. There is a clear public good in having a confidential medical service. The fact that people are encouraged to seek advice and treatment, including for communicable diseases, benefits society as a whole as well as the individual. Confidential medical care is recognised in law as being in the public interest. However, there can also be a public interest in disclosing information: to protect individuals or society from risks of serious harm, such as serious communicable diseases or serious crime; or to enable medical research, education or other secondary uses of information that will benefit society over time.
2. 37. Personal information may, therefore, be disclosed in the public interest, without patients’ consent, and in exceptional cases where patients have withheld consent, if the benefits to an individual or to society of the disclosure outweigh both the public and the patient’s interest in keeping the information confidential. You must weigh the harms that are likely to arise from non-disclosure of information against the possible harm both to the patient, and to the overall trust between doctors and patients, arising from the release of that information.
3. 38. Before considering whether a disclosure of personal information would be justified in the public interest, you must be satisfied that identifiable information is necessary for the purpose, or that it is not reasonably practicable to anonymise or code it. In such cases, you should still seek the patient’s consent unless it is not practicable to do so, for example because:
   1. (a) the patient is not competent to give consent, in which case you should consult the patient’s welfare attorney, court-appointed deputy, guardian or the patient’s relatives, friends or carers (see paragraphs 57 to 63)
   2. (b) you have reason to believe that seeking consent would put you or others at risk of serious harm
   3. (c) seeking consent would be likely to undermine the purpose of the disclosure, for example, by prejudicing the prevention or detection of serious crime, or
   4. (d) action must be taken quickly, for example, in the detection or control of outbreaks of some communicable diseases, and there is insufficient time to contact the patient.

1. 39. You should inform the patient that a disclosure will be made in the public interest, even if you have not sought consent, unless to do so is impracticable, would put you or others at risk of serious harm, or would prejudice the purpose of the disclosure. You must document in the patient’s record your reasons for disclosing information without consent and any steps you have taken to seek the patient’s consent, to inform them about the disclosure, or your reasons for not doing so.