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The National Health Act not only obliges all healthcare establishments to create and maintain a health record for every user of the establishment, but also enjoins them to respect patient confidentiality and specifies the circumstances in which patient records can be accessed.

Code of Ethics for Healthcare Quality Professionals

Sections 15 and 16 cover access to records. They may also, with the authorisation of the patient concerned, examine health records in the context of delivering treatment. There are other statutes that include confidentiality clauses regarding particular types of medical information see Box 6. Patients have a right to expect that information about them will be held in confidence by health care practitioners. Confidentiality is central to trust between practitioners and patients. Without assurances about confidentiality, patients may be reluctant to give practitioners the information they need in order to provide good care.

All results of HIV tests conducted on alleged sexual offenders under this Act must be kept in a locked cupboard accessible only by the head of the health establishment. The results should be given, in a sealed envelope, only to the Investigating Officer, who will, in turn, pass sealed duplicates to the alleged offender and the survivor.

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A copy of the results must be kept by the health establishment which may, if applicable, make them available to the prosecutor in the event of court proceedings relating to the alleged sexual offence. Access to the confidential information contained in the J88 form is legally privileged while a police investigation is underway, but may be disclosed to the defence lawyer with the consent of the police investigator and the public prosecutor if he or she has obtained a court order.

Records of termination of pregnancy must be made by the practitioner and the person in charge of the facility.

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The person in charge of the facility must notify the Director-General within one month of the termination, but without including the name or address of the woman concerned. In the case of HIV status, the exception is if the child is below the age of 12 and lacks the maturity to understand the implications, in which case the parent or care-giver, a child protection organisation or the person in charge of a hospital may consent to disclosure on his or her behalf.

Identification of Responsibility. Quality of Secondary Data.

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The institutional researcher shall ensure that all reports of projects are complete; are clearly written in language understandable to decision-makers; fully distinguish among assumptions, speculations, findings, and judgments; employ appropriate statistics and graphics; adequately describe the limitations of the project, of the analytical method, and of the findings; and follow scholarly norms in the attribution of ideas, methods, and expression and in the sources of data.

The institutional researcher shall document the sources of information and the process of analysis in each task in sufficient detail to enable a technically qualified colleague to understand what was done and to verify that the work meets all appropriate standards and expectations. The institutional researcher shall establish clear guidelines about confidentiality issues within the institutional research office. Storage and Security. Release of Confidential Information. The institutional researcher shall permit no release of information about individual persons that has been guaranteed as confidential, to any person inside or outside the institution except in those circumstances in which not to do so would result in clear danger to the subject of the confidential material or to others; or unless directed by competent authority in conformity with a decree of a court of law.

Special Standards for Data Collection. Balancing Privacy Risks Against Benefits. The institutional researcher shall, at the design stage of any project, thoroughly explore the degree of invasion of privacy and the risks of breach of confidentiality that are involved in the project, weigh them against potential benefits, and make therefrom a recommendation as to whether the project should be executed, and under what conditions.

Developing Specific Guidelines.

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Where appropriate, the institutional researcher shall adopt a written description of any specific steps beyond the regular guidelines within the institutional research office that are necessary during a specific assignment to ensure the protection of aspects of privacy and confidentiality that may be at specific risk. Disclosure of Rights. The institutional researcher shall ensure that all subjects are informed of their right of refusal and of the degree of confidentiality with which the material that they provide will be handled, including where appropriate, the implications of any freedom of information statute.

Any limits to confidentiality should be made clear. Appraisal of Implications. The institutional researcher shall apprise institutional authorities of the implications and potentially binding obligations of any promise to respondents regarding confidentiality and shall obtain consent from such authorities where necessary. Development of Local Codes of Ethics. The institutional researcher should develop and promulgate a code of ethics specific to the mission and tasks of the institutional research office and should strive to cooperate with fellow practitioners in the institution in developing an institution-wide code of ethics governing activities in common.

Custody and Archiving. The institutional researcher shall apply all reasonable means to prevent irrevocable loss of data and documentation during its immediately useful life; and, being aware of the role of data as institutional historic resource, shall act as an advocate for its documentation and systematic permanent archiving.

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Assessment of Institutional Research. The institutional researcher shall develop and implement regular assessment tools for the evaluation of institutional research services.

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  6. Institutional Confidentiality. Integrity of Reports. The institutional researcher shall make efforts to anticipate and prevent misunderstandings and misuse of reports within the institution by careful presentation and documentation in original reports, and by diligent follow-up contact with institutional users of those reports. External Reporting. The institutional researcher shall seek opportunities to contribute to and participate in research on issues directly related to the craft and in other professional activities, and shall encourage and support other colleagues in such endeavors. The institutional researcher should honestly acknowledge the work of and the contributions made by others.

    Integrity of the Profession. The institutional researcher should work toward the maintenance and promotion of high standards of practice. The institutional researcher should uphold and advance the values, ethics, knowledge, and mission of the profession. The institutional researcher should contribute to the knowledge base and share with colleagues knowledge related to practice, research, and ethics. False Accusations.

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    The institutional researcher shall take care not to falsely demean the reputation or unjustly or unfairly criticize the work of other institutional researchers. Incompetence of Colleagues. Unethical Conduct of Colleagues. The institutional researcher shall take appropriate measures to discourage, prevent, identify, and correct unethical conduct of colleagues when their behavior is unwittingly or deliberately in violation of this code or of good general practice in institutional research.