Handling information: Some ethical issues

Abstract

<h4>Background</h4>General practitioners are increasingly involved in a range of activities which require the use of data from patients' case notes. These activities include audit, evaluation and research. Any use of patient data has the potential to breach patient confidentiality and privacy. However, at present the requirements in terms of obtaining informed consent vary. Research is usually acknowledged as requiring consent, but this is not always the case for audit and evaluation activities.<h4>Objectives</h4>The aim of this paper is to define audit, evaluation and research activities in general practice and to clarify the ethical issues involved in using patient data for these purposes. We argue that the ethical issues raised by accessing patient case notes are similar for all of these activities.<h4>Discussion</h4>The ethical obligation to obtain patient consent prior to accessing or using patient information is the same for many general practice audit, evaluation and research activities. However, the avenues for obtaining ethical clearance may be hard to access for GPs. In addition, the special relationship between patients and their GP and the requirements specified by health research ethics committees such as de-identification of case notes create problems for these activities in general practice.