Ethics Guidance for Occupational Health Practice 9th Edition - Book - Page 51
Consent for the preparation and release of an occupational health
report
Principle of no surprises
3.64. The overriding principle that occupational health professionals should apply in
producing reports is one of ‘no surprises. A worker participating in an
occupational health assessment should be clear about the process in which they
are engaging and what will be reported about them to a third party (employer,
insurer, pension scheme, occupational health provider etc).
3.65. Explanations should be given in a way that the worker is likely to understand,
and deliberate omission in describing the outcome of an assessment is ethically
unacceptable. The most transparent method of avoiding surprises is to explain
the content of the report during a consultation and to offer to show the worker
a copy before sending it to the recipient.
3.66. This approach underpins the current GMC guidance on Confidentiality 31 .
Paragraph 115(d) states that a doctor should:
“Offer to show your patient, or give them a copy of, any report you write about
them for employment or insurance purposes before it is sent unless:
They have already indicated that they do not wish to see it.
Disclosure would be likely to cause serious harm to the patient or anyone else.
Disclosure would be likely to reveal information about another person who does
not consent.”
Although this duty is set out specifically for medical practitioners within GMC
Confidentiality guidance, other health professional bodies do not
provide equivalent detailed direction. Applying the GMC framework promotes
consistency across the multidisciplinary workforce, and upholds the principles
of confidentiality, autonomy, and professional integrity.
3.67. This level of prescription is easier to achieve with a face-to-face consultation in
a traditional site-based service than with remote service delivery models.
However, the ethical principle of ‘no surprises’ stands regardless of the practical
means by which it is achieved, and occupational health professionals should
ensure that innovation in service delivery is not allowed to compromise
fundamental tenets of professional practice.
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