Confidentiality - CRASH! Medical Review Series

[@davidrose555]

Thank you, Dr. Paul Bolin. Not my favorite topic but it is asked on 'boards.' As always...you are the topper.

[@fatimasuleman1980]

Thank you so so much Dr Paul.. you are really doing a great job!

[@cliffordcrimson7124]

In the "threat to others" section, unfortunately many legal departments never actually get in touch with the potential victims. The call typically goes to a paralegal who can't do anything even if they wanted to, and then gets put into the bottom of the pile of work for the attorney. They then call the police department, who are already overloaded with pointless 911 calls, and it gets passed up to a detective who has WAY more important things to do than call somebody who might possibly be in some degree of danger. There's no practical way to prevent this besides allowing doctors and nurses to contact people in danger.

[@cliffordcrimson7124]

U.S. citizens can join the military at 17 with parent's consent. Part of the consent form is signing their medical rights to the child, which is very necessary if the child is wounded in combat or training. It would be very difficult to make a phone call from the middle of the Pacific to ask if somebody's kid could have a steroid shot.

[@soniasun1]

thank you so much

[@cajal6]

Reportable conditions violate patient privacy and dignity. There is no legitimate government interest in the vast majority of reportable conditions. Unfortunately, governments also give themselves the power to share your identifiable medical records for research purposes without patient consent or even notification! This must stop!

[@pwbmd]

It's important to understand that when a condition is reported, the only thing that's reported is that a case was identified. It is not linked to a name. At most, it will be linked to a person's demographic (age, gender, race, county of residence, etc.). It's important for health departments to know these things because if there's an outbreak in a geographic area or among a certain population, they can make interventions to address the matter. It's also important that an elementary school, for instance, know that a student had measles or chickenpox or some other infectious disease that could affect other people. But I do understand your concerns!

[@cajal6]

@@pwbmd That's simply not true. Cancer registries, for example, collect vast amounts of identifiable information as well as diagnostic and treatment data (why are they entitled to know how someone's cancer was treated?). In Pennsylvania, the list of reportable fields is 5 pages long (see page 237 of their reporting guidelines - www.health.pa.gov/topics/Documents/Reporting-Registries/PCR%20Reporting%20Manual.pdf). And that's just the initial data import. Federal and state law authorized public health departments to review patient medical records for life, just because someone once had cancer. For HIV, the CDC collects an enormous amount of data. This is their current form. www.cdc.gov/hiv/pdf/guidelines/cdc-hiv-adult-case-report-form-2023.pdf Why does the CDC need to know someone's sexual orientation, for example? In addition, the CDC collects blood samples from all HIV+ people, sequences the viral genome, and builds phylogenetic trees. This identifies clusters of sexual partners and IV drug users. This is done without patient knowledge or consent, and the data are available to law enforcement in states with HIV criminalization laws. www.hivlawandpolicy.org/projects/molecular-hiv-surveillance These data sets can be linked. Since cancer registries and HIV registries both have Social Security Number, it's trivial to link records. The Massachusetts Cancer Registry bragged about doing exactly this on a recent webinar. No patient consent was obtained b/c this was classified as a "public health activity" so human subjects research protections (like informed consent) don't apply. kzbin.info/www/bejne/bl6ZmKR7mKiDf8k These are just a few examples off the top of my head. Don't even get me started on Prescription Drug Monitoring Programs or All Payer Claims Databases.

[@dougn2350]

The reality of doctor/patient confidentiality is this: Health care providers can break confidence for almost any reason. Be careful what you admit to a physician or therapist. Example: Alabama has made it a felony for a pregnant woman to have an abortion even if its done in a state where abortion is legal. Her doctor in Alabama is required to report the womans procedure or the doctor can lose his/her license. I'm not making this up.

[@Anonymous_Anon882]

That’s America.

[@yahyame111]

Abortion is killing a child! 😢😢

[@pwbmd]

It's absolutely shameful what's been going on with patient privacy in some of these states. These politicians have a lot of goddamn nerve sticking their noses up ladies' underwear.

[@threebrightstars7570]

How does telling a patient's target (that they say they're going to kill) violate hipaa? Why isn't admitting them to a psych unit enough to keep the target safe?

[@antoineetcheverry2610]

Then you can call the police and they'll do the job of finding the target (if the patient clearly threatens its life or someone else's life and it looks real, for example they have a clear plan to acheive their will)