Abstract This paper examines the various steps taken in hospital radiology departments to ensure patient privacy and confidentiality. In particular, the paper studies the increasing availability of these images online -- or at least their computerization and accessibility from outside the department and even the hospital. The paper studies the HIPAA (Health Insurance Portability and Accountability Act) regulations regarding patient confidentiality and asks how those regulations apply to the current situation.
A case study of the Health Insurance Portability and Accountability Act and ethical concerns surrounding the confidentiality of computerized medical records.
1,800 words (approx. 7.2 pages), 8 sources, 2006, $ 71.95
Abstract This paper discusses how computerized medical record-keeping facilitates improved access and transmission of medical information and has been argued as instrumental in ensuring that patients receive appropriate care in a timely manner. This paper then reviews the issues of confidentiality that have emerged from ethical concerns of misuse of patient information at the hands of insurance providers, health care associates, and even physicians themselves.
From the Paper "Confidentiality in Computerized Medical Records Description of Case Example Dudley (2004) indicated that confidentiality of patient records has been a contended issue in health care since the advent of transforming paper records into digital records. The Health Insurance Portability and Accountability Act (HIPAA) was designed to alleviate these concerns and was enacted in April of 2003. However, critics and case research indicates that the HIPAA has not done enough in terms of promoting patient confidentiality and fails to protect the patient's medical information, even in areas of interest that are specifically covered by the legislation (Dudley, 2004). Revisions to HIPAA are to go into effect on March 16 of 2006, but it remains uncertain as to whether these revisions will satisfactory resolve the existing disparities in distribution of protected information. "
Abstract This paper defines privacy, confidentiality and security. It distinguishes between the contrast and similarities of privacy, confidentiality and security. The paper specifically focuses on the importance of privacy, confidentiality and security in maintaining medical records and other private and confidential information.
From the Paper "In conclusion, confidentiality must be protected for patients accessing their medical records online via the internet. HIPAA requires standards for the development and implementation of security and privacy. Security is important to protect the privacy of the patient's medical records. Patients accessing their medical records via the internet should us a method of encryption to protect confidentiality. The patients should have a password and user identification to log into the computer system. The patient should only give the internet identification and password codes to their healthcare power of attorney or person acting on their behalf."
Abstract In this article the writer discusses that the use of the Internet has increased the risk of a patient's health information being read by persons other than the intended receiver. The villains range from insurance companies attempting to determine if a patient has what they consider to be a pre-existing condition to a co-worker who is inquisitive about why their colleague was in the room down the hall. The writer notes that today, with the Internet, with a click of a button, anyone can, with the right information, have access to personal health information even if she is not providing care for the patient. In an attempt to nullify that access, confidentiality statements are used. The writer notes that the intent is to inform the recipient of their responsibility in handling the information and questions wether this is enough.
Outline:
Expansion of Duty to Harm and Protect
Ways to Reduce Risk
Privacy and Confidentiality Confidentiality Statements
From the Paper " Healthcare has become a field or service where it is important to recognize that the duty to warn or the duty to protect is not limited to provider and client. This responsibility extends to third parties as well. An example of this responsibility is the recent case of the Atlanta, GA attorney who was diagnosed with a rare form of contagious tuberculosis. The attorney traveled outside of the country to several other countries with his new wife, on their honeymoon. At the time of travel, he was considered by the Center for Disease Control, as highly contagious. The travel included airplanes, trains, buses and automobiles. As anyone who has traveled on any of these modes of transportation knows, the proximity between him and the other passengers was close. Although the attorney denies it, the CDC states that they warned him to avoid travel, especially travel outside of the country. "
Abstract The paper discusses the ethics of the medical care non-disclosure agreement between doctor and patient, which ensures that patients have the freedom to be absolutely honest with their physicians. Frequently the lives of patients depend upon the assurance of confidentiality, which ensures that patients will release all the information necessary to be treated in a targeted and effective way. The paper highlights that the American Medical Association has provided guidelines for doctor-patient confidentiality and its maintenance, particularly as relevant to computer databases. The paper discusses the general guidelines for the relationship between physicians and their patients, along with the maintenance of their confidentiality levels.
From the Paper "To provide optimal protection of privacy, the computerized medical database should be online to the terminal only when computer programs with the necessary authorization, and specifically requiring the data, are in use. No person or entity outside of the clinical facility should have access to any online computerized database with medical records of patients who can be identified via the program. This ensures continued doctor-patient confidentiality, which belongs to the patient according to standard medical ethics, as well as the law."
Abstract This paper discusses a case study concerning a patient infected with hepatitis B and her doctor's obligation to respect the patient's rights to confidentiality. The paper explains that, in this particular case, the patient's autonomy is not respected. The patient is not only competent but well-informed about the hepatitis B antigen, but the doctor insists on focusing on the patient's sex life when unprotected sex is only one of five possible causes of hepatitis B. The paper points out that the crucial point in this case is that the doctor makes an agreement with her over consent. The paper then argues that the doctor should maintain patient confidentiality.
Abstract A case study whereby a company psychiatrist shared a co-workers personal information with other colleagues. The paper states that we all share personal information with employers, but most maintain confidentiality. However, there are times when personal information is used against an employee (such as private relationships of two individuals in the same workspace).
From the Paper "Famous people have long complained about having no privacy, and continue to go to great lengths to protect what little of it they can. Today the issue of privacy affects everyone and is becoming a bigger challenge in the workplace. Mr. Charnell discussed employee privacy versus the release of medical information. Here we will discuss a few more of the pervasive intrusions into our privacy in the workplace."
Abstract This paper analyzes the ethical code for social workers that emphasizes the confidentiality of the client and suggests that the privacy and the trust that a client puts into the social worker must not be breached regardless of the situation.
Abstract This paper argues that, while patient and doctor confidentiality is an important medical ethic that serves an important function in increasing patients' trust in health care, it still must have limitations imposed upon it out of consideration for the issues of public health, such as when a doctor is treating a patient with a highly contagious disease.
From the Paper "The principle of patients' rights to privacy, or the ethical basis of patient and doctor confidentiality, has recently come under increasing threat. This principle states that a patient's medical records, including any conversations he might have had with his doctor, are confidential and private and regarded as so by the law. The defenders of this ethical and medical principle, such as Dodeck and Dodeck, authors of "From Hippocrates to Facsimile," argue that this principle is as old as medicine itself and is a "fundamental ethical principle since the Hippocratic Oath." More importantly, supporters of patient privacy rights argue that patient and doctor confidentiality is the basis upon which the medical practice is built (Dodeck and Dodeck). There is little doubt that this argument is partly right. The knowledge that whatever patients may reveal to their doctors is confidential, encourages patients to visit and confide in doctors. Naturally, this improves health care in society. However, others such as Dr. Margaret A. Hamburg, an employee in the U.S. Department of Health and Human Services, contend that there are cases in which the consideration of whether society will benefit from, or be harmed by, the principle of privacy must be considered as a basis for violating privacy. While one may understand the importance of the principle of patient and doctor confidentiality and the positive contributions that it has made to the healthcare in societies, the fact is that the modern world is confronted by many deadly and easily spreading diseases such as AIDs or Ebola, making it important to redefine the concept of patient and doctor confidentiality as only applying in cases where there is no threat to public health or the life of another person. The Hippocratic Oath should not, and must not be used to protect the privacy of patients with deadly contagious diseases, allowing them to pose as a threat to the health and well-being of others, or the confidentiality of patients with criminal intents towards others and, therefore, needs to be redefine to permit doctors to report such cases to the proper health authorities thus, enabling doctors to fulfill their responsibilities towards their society."
Abstract This paper examines the security, confidentiality and international issues at Dell, Gateway and IBM Web sites. It looks at how the Dell and IBM websites address the international market by displaying pages in la language of choice. It explores Gateway's use of English and Spanish only and its smaller global reach. It notes a similar approach of all three websites to privacy issues.
From the Paper "The Internet makes it possible for sellers to reach buyers that previously would have been unable to purchase goods and services due to geographic limitations or even because they ..."
Abstract The paper discusses the scenario of a city trained Registered Nurse who returns to her hometown where at every turn confidentiality is challenged. The paper provides other examples of typical situations in small towns, rural or remote services where patients tend to be known and health professionals are pressured to divulge information.
From the Paper "In 2004, new Ontario legislation changed how nurses are to view private and confidential health information. The Personal Health Information Protection Act (PHIPA) and the Quality of Care Information Protection Act (QOCIPA) spell out rules for managing patient health information and access to such information. All matters of privacy are important to nursing, yet this paper shows special challenges found in smaller communities, or remote areas, in that local ideas of confidentiality may be quite different. Yeo & Moorhouse explained a scenario of a city-trained nurse who returned to the small community in which she grew up, after several years of nursing in urban hospitals."
Abstract This paper presents a case study of a teacher in a rural environment who broke the confidentiality of a student. It explains the case and then discusses the rights of students in general. The paper presents and discusses laws that exist to protect those student rights. Finally, the paper describes how this particular case was resolved with the teacher and presents the writer's personal concluding remarks.
Table of Contents:
Introduction
Rights and Law
Reflection
Concluding Remarks
From the Paper "Also, a farmer who taught school as a young man called on Ms. X at the school and just happened to speak of his own days as a teacher and how one had to learn to maintain confidentiality regarding each and every student as one of the profession's challenges. Naturally, all of these events were known to us because we heard our parents and family friends discussing them, in the spirit of a decent approach to correcting an unthinking teacher, letting her know that the community expected her to respond to the boy who could be difficult, in awareness of his home life. In hindsight, it is obvious that Ms. X received the message kindly yet clearly that her remarks were intolerable, must never occur again, and that the community expected her to address the student and his classmates differently."
Abstract This paper examines how social workers, like many other professions, are faced with a number of ethical concerns at work and attempts to examine some of the social work values concerning confidentiality on a macro-systems level. It looks at how there are various professional codes that address confidential information and how there is a central ethical concept in the professional-client relationship, along with veracity, integrity, fidelity, charity, and compassion.
Outline
Introduction
Ethical Concept
Confidentiality and Privacy
Boundaries
Ethical Decisions
Challenges
E-Therapy
Videoconferencing
Maintaining Electronic Confidentiality Position on Issue
Conclusion
From the Paper "One of the latest trends in social work is e-therapy websites which are ?run by a variety of professionals, including social workers, and offer a wide range of services for a number of issues (Finn, 2002).? E-therapy involves the ?exchange of one or more asynchronous email messages between a practitioner and a client. Some online practitioners offer ?chat,? in which messages are exchanged in real-time, or two-way video conferencing, in which video images are available to the same time email messages are exchanged (Finn, 2002).? These recent trends threaten to compromise the confidential exchanges between a client and social worker."
Abstract This paper examines how there can be no doubt that confidentiality is one of the core doctrines of ethical medical practice and has been so since ancient times and how the GMC and other professional organisations stipulate patient confidentiality as an ethical prerequisite, but, crucially, permit breaches of confidentiality in certain circumstances. It provides a comprehensive review of the ethical and legal problems faced by a physician in the management of a patient with a communicable, sexually-transmitted illness.
From the Paper "Patients expect to have to divulge the most intimate information to their doctors on a professional basis in order that they receive the most appropriate care. This exchange of information is in return for the [implicit] assurance of confidentiality. Patients would be less willing to present to their doctors if this were not the case and the utilitarian ethic would declare that the harm that this would cause in the long run would far overshadow any benefits. There is also a deontological, or "duty-based" ethic, which would propose that Peter's GP has a "duty" to keep the contents of their consultation in confidence, for this is inextricably linked with the privilege of receiving the information and with upholding the autonomy of the patient. A utilitarian ethic could also propose that a breach of confidentiality would lastingly taint Peter's view of the medical profession."
Abstract This paper examines two sections of the APA's code of ethics: confidentiality and discrimination. It looks at an instance wherein the APA code of ethics offends the writer's personal beliefs and an instance where the code is in accordance with the writer's beliefs. The paper explains how one must never allow personal sensibilities to intrude upon the professional discharge of duties. The paper then discusses the case of a daughter accusing her father of rape, and the ethical obligations of the counselor according to the APA code of ethics. In addition, the writer relates that she values confidentiality, but believes that confidentiality cannot be absolute and something as serious as an allegation of sexual assault must be brought to the attention of the father - as long as reasonable precautions have been undertaken.
From the Paper "To begin with, this writer finds little in the APA Code of Ethics that is cause for concern. In particular, section 3.01 of the APA's 2003 Code of Ethics takes a strong stance on the issue of unfair discrimination, stating that discriminating against any party on the basis of age, gender, race, religious affiliation or sexual orientation - among several others - is abominable and unacceptable. As someone who has long been opposed to discrimination in all its forms, obeying this injunction is something that will cause little trouble for this counselor. On the other hand, my own strong feelings about the need to maintain confidentiality - and my recognition that confidentiality is something which cannot always be maintained - is an area that is sure to cause me some significant angst insofar as my professional obligations run counter to my own personal belief system and my own conviction that confidential disclosures from a young person should not be circulated to other members of the group."
