The Erosion of Patient Confidentiality
The medical Profession recognizes that patients have a number of basic rights. These include but are not limited to the following: the right to reasonable response to his or her requests and need and needs for treatment within the hospital’s capacity. The right to considerate, respectful care focused on the patient’s individual needs. The right of the patient to make health care decisions, including the right to refuse treatment. The right to formulate advance directives. The right to be provided with information regarding treatment that enables the patient to make treatment decisions that reflect his or her wishes. The right to be provided upon admission to a health care facility with information about the health care provider’s policies regarding advance directives, patient rights, and patient complaints. The right to participate in ethical decision making that may arise in the course of treatment. The right to be notified of any medical research or educational projects that may affect the patient’s care. The right to privacy and confidentiality of information. The right of an authorized representative to exercise these rights behalf of the patient if the patient is unable to do so.
Confidentiality of information is an important basis for a good patient-physician relationship. The physician-patient relationship is confidential. The physicians duty to keep information private and confidential derives from ancient physician oaths, presently unchanged at their core, and from more recent legal recognition that an individual has the right to keep those things private which he desires to be kept private. Rules of the physician-patient confidentiality and other doctrines protect ones’ privacy.
In the opinions of many in today’s society this right seems to be dwindling. Many patients are aware of the technological advances in data storage and retrieval. Many are also aware of the growing problem with cyber-crimes. The number of cyber-crimes in the last decade has increased at an alarming rate. There have been numerous types of attacks or misuses detected in the last 12 months. The threats that are most notable are but not limited to:
Viruses, insider abuse of net access, unauthorized access by insiders, system penetration by outsiders, theft of proprietary info, sabotage, and financial fraud.
From at least the 1970’s through the present, various groups such as the Privacy protection Study Commission, and the American Medical Association(AMA), have studied privacy protections in the electronic health records systems. They have also advocated various safeguards which are instructive to Clinical Data Management(CDM).
For example, the AMA requires “the utmost effort and care” to protect the confidentiality of computerized medical records. Among the AMA’s guidelines are requirements that both patient and physician be advised about every existence of computerized medical databases. In addition, the AMA requires that this information be communicated to the patient and physician before the physician releases the information to the database. Most importantly, the AMA characterizes fully disclosure to the patient of this information as necessary to obtaining the patient’s fully informed consent to treatment.
Many safeguards have been put in place to protect physician-patient confidentiality, but the truth is technology is growing almost exponentially, but security of private information has been neglected. If medicine is going to incorporate this new technology we must not overlook one of our basic rights, privacy and confidentiality of information. There is much work that needs to be done to protect this.
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