title: To tell or not to tell? Professional and lay perspectives on the disclosure of personal health information in community-based dementia care.
abstract: Developments in information technology and the ongoing restructuring of health services to increase provision in community settings militate in favour of a streamlining of communications and the exchange of information about patients among health and social care providers. Yet the principles of confidentiality and privacy appear to inhibit this process. In order to explore the practical, ethical, and legal imperatives attendant upon personal health information exchange, we conducted a series of interviews with professional care providers, persons with early-stage dementia, and their family caregivers. The findings indicate some degree of discordance. Professionals reported valuing disclosure both to colleagues and family caregivers on the basis of its being in the patients' best interests. Patients also valued inter-professional exchange, but sought strong control over disclosure to family members. Family caregivers valued being kept informed of the patient's condition, even without the latter's consent. Implications for research and policy are discussed.
authors.affiliation: Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
authors.forename: C Shawn
authors.initials: CS
authors.lastname: Tracy
authors.forename: Neil
authors.initials: N
authors.lastname: Drummond
authors.forename: Lorraine E
authors.initials: LE
authors.lastname: Ferris
authors.forename: Judith
authors.initials: J
authors.lastname: Globerman
authors.forename: Philip C
authors.initials: PC
authors.lastname: Hébert
authors.forename: Dorothy M
authors.initials: DM
authors.lastname: Pringle
authors.forename: Carole A
authors.initials: CA
authors.lastname: Cohen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003156:Community Mental Health Services; D003219:Confidentiality / Q000941:ethics*; D003704:Dementia; D030881:Disclosure / Q000941:ethics*; D005260:Female; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D008297:Male