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News and Updates from today's Caldicott Guardian Ethical Decision Making & The Duty of Candour Conference

Conference Chair Christopher Fincken Former Chair 2012-2017 UK Caldicott Guardian Council & Caldicott Guardian Marie Curie opens the day with a National Update including understanding ethical decision making within the context of the Caldicott Guardian role.

This is followed by a presentation from Dr Andrew Stanners Consultant Geriatrician The Mid-Yorkshire Hospitals NHS Trust & Trustee The UK Clinical Ethics Network who gave an extended session on 'Ethical Decision Making: Principles and Practice' and covers:

• ethical decision making in clinical practice
• ethical principles and frameworks to support moral decision making
• making difficult decisions: understanding conflicting ethical principles
• integrating clinical ethics into clinical decision making
• analysis of cases using ethical decision making frameworks
• advice for Caldicott Guardians 

Pre conference abstract

This session explains ethical decision-making, broadly understood, and then focusses on decision-making in confidentiality cases. Ethical decision-making is necessary in situations where two or more options present themselves and it is not clear which is the right option to choose; the competing choices may even present themselves as a dilemma. Ethical decision-making can thereby be contrasted with technical decision-making. There are three key theories that explain ethical decision-making—character/virtue, rule and utility based ones—and each has strengths and weaknesses. A practical framework for ethical decision-making will encompass each one. I will explain a framework, from the UK Clinical Ethics Network, that does this, and in doing so will bring out the strengths and weaknesses of each theory. Overall, the framework is a rigorous one which is also able to accommodate competition between principles. Importantly, the framework requires decision-makers, first, to be sensitive to ethical aspects of the situation and, second, to identify arguments for and against selected options in order to identify the option backed by the strongest argument.

Decisions in confidentiality cases may present particular difficulties to decision-makers since they pit the interests of individuals against the public interest. One way to conceptualise this type of case is in terms of harms, i.e. thwarting of interests, and how they can be balanced against each other. So I will first briefly explain problems inherent in balancing harms and, second, look more closely at potential harms to individuals—namely loss of privacy—and to the public—namely thwarting of the public interest—in confidentiality cases. One potential harm to the public is if confidential patient information isn’t available for healthcare research, but this harm cannot normally be construed as serious enough to justify a breach of confidentiality. However, individuals may consent to use of their confidential information outside the scope of direct care in order to benefit medical research.

Andrew's Biography

Andrew is a Consultant Physician with the Mid Yorkshire Hospitals NHS Trust, where he is chair of the Clinical Ethics Committee, and Tutor in Healthcare Ethics at the University of Leeds. He is a trustee of the UK Clinical Ethics Network. He qualified in medicine from the University of Southampton and trained as a physician for older people in Bristol, Bradford and Leeds. He trained in Healthcare Ethics at the Inter-disciplinary Ethics Applied Centre at the University of Leeds. His research interests are moral character, choice and assisted suicide.

Helen Dyer Chair Caldicott Guardian Northeast Regional Network updates delegates on 'Ethical dilemmas and difficult issues in practice', her presentation covered:

• what are the difficult decisions for Caldicott Guardians
• ethical decision making: my experience
• issues we have seen in the South West Caldicott Network 

In her presentation Helen commented:

'what is difficult for caldicott guardians?'

'You need to understand your organisational requirements – organisations change all the time.'

'Make sure your Caldicott Guardians role fits your organisation.'

'Use the Caldicott Guardian principles like a checklist, consider them all.'

Full powerpoint presentation

Helen's Biography

Helen Dyer is Caldicott Guardian for ExamWorks UK, the British subsidiary of a US corporation. She is the company’s Director of Nursing and the biggest component of her work is concerned with assessing patients for continuing health care, under contract from the NHS. She is a member of the UK Caldicott Guardian Council and established the Councils North East Regional network.

The session facilitated by Helen will explore some of the challenges in practice faced by those endeavouring to provide a Caldicott function for their organisations’ service users and recognises that “for Caldicott Cardigans, one size fits no-one”

Future conferences of interest:

Caldicott Guardian Leadership Summit 2018
Wednesday 17 October 2018 
The Studio Conference Centre

Caldicott Principles & Information Sharing in Adult Safeguarding
Friday 30 November 2018 
De Vere West One Conference Centre

12 July 2018


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