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PaperclipPerfector  9mo ago (text post)   3157 thread views

Small-Scale Question Sunday for September 29, 2024

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Another question for the medics among you. Shortly after I started in my previous job ~two years ago, my employer booked me in to undergo a full physical exam in a clinic. I underwent the exam and they gave me a clean bill of health. It's recently come to my attention that I may have a mild medical condition (nothing to be concerned about, before you ask), so I wanted to ask the clinic for the detailed results of my medical exam, to find out if the condition was present two years ago. They gave me a form to fill out, asking for my personal details and what information I want access to.

The form included this clause:

In certain cases, some data will be withheld by [clinic]; if it is the medical professional’s opinion that it is not safe to the data subject (yourself) to do so, or if [clinic] are not legally allowed to do so. Guide to Professional Conduct and Ethics for Registered Medical Practitioners (Amended) 2019, states that “Patients have a right to get copies of their medical records except where this is likely to cause serious harm to their physical or mental health.”

Pardon my French, but what the fuck? How grandiose and paternalistic can you get? Under what circumstances could it possibly be acceptable that a medic can arrogate themselves the responsibility to decline to inform an adult of sound mind that they have a serious medical condition? What is this, fucking Love Story?* "You have cancer, but I thought that finding out that you have cancer might make you sad, so I decided not to tell you that you have cancer."

*A movie in which a doctor tells a man that his wife is terminally ill without telling the wife herself.

This is a US thing? I'm pretty sure that in the UK, this wouldn't fly at all. We're obliged to disclose all relevant information to our patients, though if memory serves there are criteria like mental incapacity where that's not strictly necessary.*

*My gut instinct was wrong. From GMC guidance:

You should not withhold information a patient needs to make a decision for any other reason, including if someone close to the patient asks you to. In very exceptional circumstances you may feel that sharing information with a patient would cause them serious harm and, if so, it may be appropriate to withhold it. In this context ‘serious harm’ means more than that the patient might become upset, decide to refuse treatment, or choose an alternative. This is a limited exception and you should seek legal advice if you are considering withholding information from a patient.

I certainly find this perplexing, I can't under any circumstances endorse people not being given medical records that they paid for (or were paid for on their behalf). I suppose this a clause more likely to be invoked in psychiatry than elsewhere, but it's not one I particularly want to use.

I live in Ireland.

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