Ethics

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Anti-radicalisation strategy: confidentiality and doctors' responsibilities

Trolley of notes on the major trauma ward at St Mary's Paddington

The Government’s anti-radicalisation ‘Prevent’ strategy creates no new responsibilities in relation to the disclosure of information.

Doctors’ legal and professional duties in relation to confidential information – including the discretion to disclose confidential information in the public interest without consent if necessary – remain unchanged.

 

Prevent duty

For our purposes, Section 26 of the Counter-Terrorism and Security Act 2015 places a high-level duty on specified health authorities to have ‘due regard to the need to prevent people from being drawn into terrorism.’ The Act does not confer new functions on any authority, rather it imposes a duty on specified authorities to consider how to prevent people from being drawn into terrorism in the exercise of their ordinary duties. In turn, health staff are placed under a general duty, as part of their ordinary work, to be alert to those who may be vulnerable to being drawn into terrorism and to refer as appropriate.

As the legislation makes clear, the Prevent duty exists in a ‘pre-criminal space’. Its purpose is to identify those at risk of being drawn into terrorism, not to identify those who already present a terrorist threat. For this reason it is best understood as part of adult – and child – safeguarding.

 

Disclosure of information

As part of the Prevent duty, where health professionals identify individuals who may be at risk of being drawn into terrorism, they will ordinarily refer them to the relevant Prevent lead. As mentioned above, the Counter-Terrorism and Security Act creates no new obligations with regard to disclosure of information. It follows therefore that information must be disclosed in accordance with the law and professional duties.

Confidential patient information can ordinarily be disclosed:

  • where it is shared within the healthcare team for the purposes of providing care and treatment to the patient – in these circumstances, consent is understood to be implied
  • where the patient explicitly consents to the disclosure
  • in the best interests of an adult who lacks the capacity to consent to the disclosure
  • where the law requires disclosure (for example under section 38b of the Terrorism Act 2000 all citizens are required to tell the police if they become aware of information relevant to the prevention of a terrorist act or securing the arrest or prosecution of someone involved in terrorism)
  • where there is an overriding public interest in disclosure.

Children and young people are owed the same duty of confidentiality as other people. Consent should be sought from children who have the relevant decision-making ability. If a child lacks the ability to make the decision, consent should ordinarily be sought from someone with the relevant parental responsibility.

 

Disclosure in the public interest

Information can be disclosed, without consent if necessary, where there is an overriding public interest at stake.

Ordinarily disclosure will be justified in the public interest where it is necessary to prevent a serious and imminent threat to public health, national security, the life of the individual or a third party or to prevent or detect a serious crime. This would also include those planning or carrying out terrorist activities or those who have carried out such activities in the past.

These duties remain unchanged following Prevent.

 

More information

Access more guidance on confidentiality and health records

Read our children and young people ethics guidance

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