Guideline 4: Patient privacy & confidentiality

Answer all of Caterina’s questions, including providing some extra detail that was not discussed in the consultation with George. As his primary carer, Caterina needs to know all of the information.

George has stated that he wants to be actively involved in all conversations about his illness/treatment. Discussing the specifics of George’s illness, particularly providing new information not already shared with George, would be against his wishes.

State that you are unable to speak with Caterina as George has stated that he would prefer that all conversations include him.

This could be an appropriate approach, however it leaves Caterina highly anxious and without information. While legally appropriate, this may not be the most sensitive approach to managing a family carer who feels they need information

Apologise for not being able to share more information, state that you are unable to discuss the specifics of George’s illness without him present, but reiterate some general points which were discussed with George and Caterina present in the consultation.

This approach is still in alignment with George’s wishes, but is also not dismissive of the important role of Caterina and the major life changes she may need to make as his primary carer. Reiterating general points that have already been discussed in the presence of George is not undermining his privacy/confidentiality as it has already been shared in his presence.

Caterina sounds anxious. Refer her to the psycho-oncologist working with your team.

While referral to psychologists and social workers is critical for some family members, it should not be used to escape challenging conversations or for all family carers. Keep an eye on Caterina’s anxiety, ask her about her coping at the next consultation, and assess the appropriateness of referral from there.