Privacy and Confidentiality

Question 1

What do Privacy, Confidentiality, and Privilege all share?

Answer 1

The idea of limiting access of others in certain respects

Question 2

Privacy

Answer 2

1. Limiting access of others to one’s body or mind, such as through physical contact or disclosure of thoughts or feelings
2. Law and ethics: privacy refers to freedom from intrusion by the state or third persons

Question 3

What is included in the “Domain of Personal Decision”?

Answer 3

Personal information, Associations, Abortion, or Bodily Integrity

Question 4

Confidentiality

Answer 4

1. Communication of private/personal info form one person to another, with expectation that the recipient will not disclose the info to a third party (i.e. Fiduciary Responsibility)

Question 5

Privileged Communication

Answer 5

A private statement that must be kept in confidence by the recipient for the benefit of the communicator

Confidential communications that the law protects against disclosure in legal settings

Question 6

How are Confidentiality and Privacy similar?

Answer 6

They each stand as polar opposites to the idea of “public”

Question 7

How are Confidentiality and Privacy different?

Answer 7

Privacy = singular
Confidentiality = two or more persons

Important aspect: relinquishing privacy is a precondition for establishing confidentiality. Confidentiality requires a relationship of at least two persons, one of whom exposes or discloses private data to the other

Question 8

What are some exceptions to the Duty of Confidentiality?

Answer 8

1. Patient permission
2. Danger to public/specific individuals
3. Mandatory reporting statutes
4. Legal process (court order)
5. Treatment, payment, and healthcare operations (HIPAA)
6. Independent medical evaluation

Question 9

Who owns the physical paperwork of the medical record?

Answer 9

The Clinician

Question 10

Who owns the information contained in the medical record?

Answer 10

The Patient

Question 11

When may minors (under 18 y.o., unmarried, childless, and not living separate from parents/independent financially) authorize release of medical records or consent to treatment?

Answer 11

STDs, contraception, substance abuse, or testing for HIV

However, if HIV testing is positive, parent/guardian MUST be notified

Question 12

Each parent in a divorce has rights to a child’s record, except when:

Answer 12

1. Child is seeking care for addiction, contraception, or STD
2. Divorce decree prohibits one parent from access
3. Parental rights have been legally terminated
   * **Step parents have NO RIGHT to medical record unless natural parents have signed a consent form

Question 13

Subpoenas

Answer 13

Used to force the release of records

NOT a court order and must be accompanied by a release from the patient

Question 14

When may a court quash the subpoena?

Answer 14

1. If disclosure of privileged info is at risk

2. If no exception or waiver compelling release of records applies

Question 15

Who has a statutory right to access all medical records?

Answer 15

Board of Medical Examiners

Question 16

What is a Fiduciary Responsibility?

Answer 16

Vulnerable person vests confidence, good faith, reliance, and trust in another.