Vision at risk

October 2009

Research

The practice of confidentiality in an Aboriginal medical service

What do GPs need to know?

Volume 38, No.10, October 2009 Pages 837-842

Jenny James

Sonya Cameron

Tim Usherwood

Background

The medical ethic of confidentiality is usually taught from a western ethical perspective based on the Hippocratic oath. This study at an urban Aboriginal medical service aimed to explore how confidentiality is understood in a community controlled Aboriginal health service, with a view to informing the training of general practitioners.

Methods

Twenty-three people, comprising staff, patients and general practice registrars, were interviewed about confidentiality between July 2007 and February 2008.

Results

Six themes were identified: overlapping contexts of confidentiality, key sensitivities, sharing of patient information, importance of consent, multiple roles, and consequences of maintaining or breaching confidentiality.

Discussion

Perspectives on confidentiality in this community included issues of social justice, the importance of public demonstrations of confidentiality, and the challenge of protecting all relationships when staff have multiple roles. Incorporation of community perspectives into the teaching of confidentiality may help doctors to understand the responsibilities of practising confidentiality in certain communities.

Confidentiality is a greatly valued ethic in Aboriginal health.1–4 Different cultures and communities bring different expectations to the concept of confidentiality.5,6 The patientdoctor relationship is enhanced for general practitioners if they understand how local community values influence these expectations.7

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Correspondence afp@racgp.org.au

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