Self-Study Modules on Tuberculosis
Module 7: Confidentiality in Tuberculosis Control
In this module, you will learn what confidentiality means in
the context of tuberculosis (TB) control. Confidentiality is an
essential issue in many different aspects of TB control. Health
care workers need to be aware of the confidentiality issues that
are relevant to patient-health care worker encounters, as well as
to the collection, management, and sharing of data gathered on TB
patients. In the treatment of TB disease, the relationship between
the patient and the health care worker is extremely important because
of the serious consequences of treatment failure. If patient information
is disclosed to unauthorized persons without the patient's permission,
the patient may be stigmatized or experience rejection from family
and friends, lose a job, or be evicted from housing. Moreover, the
health care worker may lose the trust of the patient, which can
affect adherence to TB treatment. Therefore, confidentiality —
the responsibility to protect a patient's private information —
is critical in TB control.
This module highlights specific situations in which a health
care worker needs to consider and protect the rights of TB patients.
It discusses general recommendations for developing trust with a
patient, limiting disclosures, negotiating conflicts, and following
due process. By using the recommendations in this module, you should
be able to protect the confidentiality of your patients' personal
information and help the program fulfill its responsibilities to
After working through this module, you will be able to:
- Explain what confidentiality is, and why it is important to
- List four serious consequences that may result from revealing
personal information without the patient's permission.
- Explain the patient-health care worker relationship and how
it is like an agreement between two parties.
- Define health care worker and third party, and explain the difference
between these two terms.
- Explain why trust is a key element in a successful patient-health
care worker relationship and three ways to develop trust.
- List four types of patient's rights and describe their purposes.
- Describe how confidentiality is an essential issue in several
of the core components of a TB control program.
- Describe how confidentiality is important in the identification
and management of TB cases and in ensuring adequate therapy.
- Describe what should be done to protect a patient's rights during
a contact investigation and screening for tuberculosis.
- Explain how other program activities, especially those involving
data collection and analysis, require measures to provide data
security and protect confidentiality.
- List the ways in which a patient's confidentiality can be protected
in any situation: in an office, clinic, institution, or the field.
Lists of new terms were introduced in each of the five core Self-Study
Modules on Tuberculosis (Modules 1-5). Please refer to the
core modules or their Glossary if you encounter unfamiliar terms
related to TB that are not defined in this New Terms section.
Look for the following new terms in this module.
authorization - permission given by the patient
to allow a third party to have access to the patient's confidential
autonomy - the right of a patient to determine
what will be done with his or her body, personal belongings, and
personal information; this concept applies to any adult person who
is mentally competent
confidentiality - the protection of information
revealed during patient-health care worker encounters, including
all written or electronic records of these encounters
consent - acceptance or approval of what is planned
or done; it involves voluntary agreement to an action, whether it
is a treatment option or a diagnostic test; the patient-health care
worker relationship is founded on the patient's consent to the care
court order - an order issued by a court mandating
DOT or, in very rare cases, detention in a facility until treatment
disclosure - the act of revealing or distributing
due process - an established course for governmental
activities or procedures, designed to safeguard the legal rights
of the individual
health care worker - any member of a team of health
professionals who care for and manage a TB patient, including physicians,
nurses, outreach workers, hospital discharge planners, pharmacists,
and social workers
informed consent - a patient's written consent
to a surgical or medical procedure or other course of treatment,
given after the health care worker has informed the patient about
the potential benefits, risks, and alternatives involved
partner notification - an activity conducted by
HIV/AIDS programs to identify and counsel the sexual and needle-sharing
contacts of HIV-infected persons; this notification is confidential
and depends on the voluntary cooperation of the patient
patient-health care worker relationship - the
basis for sharing information, communicating beliefs and feelings
that affect care, and building trust in the value of the interaction
patient-identifiable information - information
in which the identity of the patient is directly included or can
privileged information - personal information
shared by the patient with his or her health care worker
routine case reporting - the required reporting
of suspected or confirmed TB cases to a public health authority
statement of disagreement - a statement filed
by the patient stating there is a disagreement with the health care
worker or institution regarding the patient's record
third party - a person or an organization not
directly involved in the care of a patient's health problem
waiver - a form that patients are often asked
to sign to allow their health information to be used by third parties