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2017-63: Expert system professional confidentiality PPCs (Call 2017-63)


The professional confidentiality of health care providers has two objectives: unimpeded access to health care facilities and the privacy of the individual patient. In some situations, the importance of confidentiality clashes with other interests such as safety and the detection of criminal offences or the interests of a surviving relative. This field of tension is discussed every time controversial dramas occur. The fact that this field of tension leads to questions is evident, for example, from the figures from the ArtsenInfoLijn (Physicians Information Line). The ArtsenInfoLijn is the information service of the Royal Dutch Society for the Promotion of Medicine (KNMG); it provides advice to physicians who are members of the KNMG and who wish to raise legal and ethical questions. Around 350 physicians use this option every month. More than 70% of the questions asked relate to professional confidentiality.

A research report by Erasmus University concludes that the individual practitioner seems to have increasing difficulty in making their own decisions on how to break the confidentiality obligation. This may mean that the discussion about whether or not to break the obligation to remain silent is avoided. In the case of social workers in a detention setting, other factors also play a role. In addition to the treatment relationship with the patient, care providers also have an advisory role; for example, counsellors advise the director of the institution in case of punishments and sanctions, but also in case of privileges or requests for early placement in a (TBS) detention clinic. Despite various publications, legislation and case law, it is not always clear to the professional what consideration should be given to breaching their professional confidentiality. Based on an action investigation, a tool is designed that offers guidance to the professional when making case law considerations in the context of professional confidentiality. An expert system can play a supporting role in (complex) legal issues. The tool does not attempt to replace the legal adviser, but provides support to improve the quality of decisions concerning professional confidentiality. Where complex circumstances play a role, the institution’s legal expert (lawyer) can elaborate on what the counsellor has already entered into the tool. The objective of this expert system is that health care professionals working within a correctional facility will benefit from faster and better-substantiated decisions regarding professional confidentiality.

Executive party

PPC PI Vught, in cooperation with Free University of Amsterdam (VU)