Patients have a right to information about relevant healthcare information. This topic looks at which information must be provided, and the appropriate manner of doing so.

Contents

Information which must be provided to patients

Communicating with patients

Sharing information with those close to the patient

Respecting the patient’s wishes

Discussion

Patients are clearly entitled to information about the range of healthcare services available to them, as well as their own health status.[1] Such information must be presented in a way that is easy to understand.[2]

Information which must be provided to patients

The National Health Act provides that healthcare practitioners must inform patients of:

1. the range of diagnostic procedures and treatment options generally available to the patient.

2. the patient’s health status, except in circumstances where there is substantial evidence that the disclosure of the patient’s health status would be contrary to the best interests of the patient;

3. the benefits, risks, costs and consequences generally associated with each option; and

4. the patient’s right to refuse healthcare services and explain the implications, risks and obligations of any such refusal.

The HPCSA Guidelines also provide that patients have a right to information about any condition or disease from which there may be suffering.

Information about any such condition or disease must be presented in a manner that is understandable and, where relevant, should include information about the:

prognosis;

diagnosis;

treatment options;

common and serious side-effects of treatment;

outcomes of treatment;

the likely time-friends of treatment; and

the expected costs.

Healthcare practitioners should always give patients basic information about the treatment they propose to provide. However, practitioners should respect the wishes of any patient who asked not to be given detailed information. Where this situation occurs, the practitioner is placed in a difficult position because, without such information, patients cannot make proper choices about treatment and care.

Communicating with patients

Wherever possible, practitioners should communicate with patients in a way that suits them. For example, electronic communications – such as email or text messaging – can be convenient and can support effective communication between doctors and patients, with appropriate safeguards.

Most electronic and telephonic communication methods pose some risk of interception – for example, messages left on answering machines can be heard by others and emails can be insecure. You should take reasonable steps to make sure the communication methods you use are secure.

Interpreters may be needed where there are language differences, or persons skilled in sign language for deaf people.

Consideration should always be given to the patient’s condition, and this may affect the pace and amount of information which is provided.

Sharing information with those close to the patient

Sharing information often extends beyond communicating with the patient only.

There are usually family members and/or friends in attendance. While being fully vigilant about preserving confidentiality, practitioners must be considerate to those close to the patient and be sensitive and responsive in giving them information and support.

Those close to a patient can play a significant role in supporting, or caring for, the patient, and they may want or need information about the patient’s diagnosis, treatment or care.

Usually, discussions with those close to the patient should take place with the patient’s knowledge and consent.

It is advisable to have early discussions about the patient’s wishes in this regard, as this can help to avoid disclosures which the patient might object to. This can also help avoid misunderstandings with, or causing offence or distress to, anyone the patient would want information to be shared with.

Details should be discussed with the patient regarding the information they want to be shared, with whom, and in what circumstances. This will be particularly important if the patient has fluctuating or diminished capacity or is likely to lose capacity, even temporarily. In these circumstances, the information should be documented in the patient’s records.

Persons close to the patient may want to discuss their concerns about the patient’s health without involving the patient. Practitioners should consider whether the patient would consider you listening to the views or concerns of others to be a breach of trust. This is particularly the case where the patient has asked the practitioner not to listen to specific people.

Practitioners are advised to make clear that, while it is not a breach of confidentiality to listen to their concerns, they may need to tell the patient about information you have received from others – for example, if it has influenced your assessment and treatment of the patient.

However, if appropriate, listening to the views or concerns of others is not in itself a breach of confidentiality, particularly where the information they provide might be helpful in caring for the patient.

Should they be approached by those close to the patient for this reason, practitioners should however take care not to disclose personal information unintentionally – for example, by confirming or denying the person’s perceptions about the patient’s health.

Respecting the patient’s wishes

Patients have a right to information about their health status. Practitioners should respect, and help patients to exercise, their rights to have access to, or copies of, their health records.

When the practitioner is satisfied that information should be released, he or she should act promptly to disclose all relevant information. This is often essential to protect the best interests of the patient, or to safeguard the well-being of others.

Where it may be beneficial to obtain information from a family member or person close to the patient, but the patient refuses, the practitioner should encourage the patient to reconsider. However, the patient’s wishes must be respected if they are unwilling to reconsider.

In certain cases, it may nonetheless be necessary to consider whether the information is necessary in the public interest.

If a patient lacks capacity to make the decision and there is no proxy decision-maker appointed, it is usually reasonable to assume the patient would want those closest to them to be kept informed of their general condition and prognosis, unless they indicate (or have previously indicated) otherwise.


[1] Booklet 5, Paragraph 6.

[2] Booklet 5, Paragraph 6.1.

[3] Booklet 5, Paragraph 6.3.

[4] Booklet 5, Paragraph 6.4.