Patient Confidentiality
Patient Confidentiality
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A Debate on Patient Confidentiality
Patient confidentiality is a set of rules that protects the information regarding a patient and to ensure the information remains between the patient and the practitioner. Confidentiality in the medical field is a core value for the health practitioners and the HIPAA regulations. It is in the code of ethics for healthcare and all practitioners are bound to follow it failure to which legal actions may be taken against the facility or the practitioner. It helps build trust between the patient and the practitioner. This is important because it will enable a patient to open up about their health problems and in turn receive proper medical attention. However, there are some instances that allow the disclosure of a patient’s information. These exceptions include when a patient gives consent to the disclosure, an order from a court of law or when the information will put either the patient or people around him or her in danger. The purpose of this paper is to debate on the patient confidentiality, whether a patient’s information should remain confidential or it should be disclosed.
Patient confidentiality should not be a thing in the medical field. Most of the time a patient delegates the responsibility of decision making to his or her family about a treatment plan. This alone breeches the patient confidentiality ethics because there is a third party involved in the sharing of the information. This could be a good thing because sometimes patients may be too sick or not in the right state of mind and a next of keen will have to be involved in the treatment of the patient sometimes without the consent of the patient.
Secondly, during the visits by physicians there are always informal advocates who are present. These may include family members or other people who have come to pay a visit to the patient or interns who need to learn one thing or another. It is always difficult to send away the family members because they usually want to know the progress of their patient. And even if you manage to keep them away during the physician visit, the patients themselves will tell them everything about their health and the progress of their treatment. This beats the point of having patient confidentiality.
Thirdly, in most cases the bills of the patients are being paid by either family members or well-wishers. It beats logic that you will have the information about this patient kept confident and not tell the people who are taking care of the patient. Then how do they know what they are paying for if they do not even know what the patient is suffering from (Riaz et al, 2017). For instance, if they want to hold a fundraising, they have to tell the well-wishers what the patient is suffering from; like cancer. This way people will empathize with the health condition of the patient and decide to give a hand to cover the bills. However, hiding this information will make people ignorant and they will assume that it is nothing serious.
Also, family members are the full support that a patient needs in hiss or her journey to recovery. What sense will it make when a patient is the only person who knows what they are suffering from and are fighting their battles alone. One could argue that a patient can talk to a therapist instead of disclosing their information to other third parties. However, there is love and emotional support in family that a patient needs which he or she cannot get by simply sharing with practitioners alone. For instance, a patient who is married cannot keep their health conditions a private matter between them and the practitioners, they will have to share that information with their partners too. It could be so unfair if the partner is kept out of light on what is going on with the health of their spouse (Hosseini, 2019). So, the fact that the family needs to know and be there for the patient, breeches patient confidentiality.
In addition to that, patients may not give full information and encounter about their health issues. In this case, practitioners will gather more information from the family members on their observations of how the patient is affected or if the patient is compliant and adheres to medication. These are tiny bits of information that will help a practitioner to prescribe the right treatment plan for the patient. The family of the patient will also help in monitoring the progress of the patient after they are discharged. They could be liable to report any negative effects the medication has on the patient and prompt for a change in the treatment plan. They can also ensure that the patient adheres to medication in order to get better. All this cannot be possible if patient confidentiality is followed to the letter.
There is no confidentiality when it comes to pediatric patients. Children cannot fully express themselves and say what their problem might be. They would vaguely point out a stomach ache, toothache or a headache. In real sense it could be more than that and that is why a parent or guardian is required. This way, the parent can talk of the symptoms they have observed and any other thing that may seem off with the health of their child. this will help a practitioner diagnose the child and recommend or prescribe medication for the child. it would not make sense at all if patient confidentiality was respected in this case.
A mental health patient would come for treatment or a therapy session and in the course of it he or she would confess to wanting to harm himself or other people. This gives direct permission for a practitioner to disclose this information because the patient is an immediate danger to himself or to others. This information could be crucial in helping save a life only if patient confidentiality is broken. It is possible that the patient said that due to their mental health status and meaning no harm but you cannot take the chance of sitting on that information without disclosing it to the police. In the end if something of that kind happens and someone gets hurt, the practitioner will still be held responsible because they had the information. In this case, how patient confidentiality will sue you instead of protecting you as a practitioner.
They say no one is above the law and that includes patient confidentiality. A court of law can give an order for the information of an individual to be disclosed. It could be a criminal whose files or medical conditions are required in order to determine if he or she is in his or her right state of mind. Releasing the information could also help in determining where this individual was at a given period, it could help prove that they are innocent in case the crime happened at the same time they had visited the hospital. This could be used as a piece of evidence in the proceedings of the case in a court of law. Failure to disclosing the required document or information will lead to charges of obstruction of justice. Therefore, with or without the consent of the patient or the ethical codes of patient confidentiality, the information will be disclosed. This will be assumed to be in the best interest of the patient and that of the public.
In healthcare facilities, medical errors occur all the time. An employee or practitioner could mistakenly disclose the information of a patient verbally or non-verbally. Sometimes the Protected Health Information (PHI) may not be as protected as it sounds due to unsecure access and unauthorized personnel could access the information. With the new technology, it is possible to hack into computers of hospitals, schools and companies (Noroozi, et al 2018). All these instances put the patient’s information at risk of being disclosed at any time. Even if HIPAA protects the right of the patient to confidentiality, once the information is disclosed it cannot be taken back. The people responsible for breeching patient confidentiality may be punished but the information of the patient will remain known regardless.
On the other hand, patient confidentiality is very important. It builds trust between the patient and the practitioner. When a patient knows that their information is safe and secure, they will be able to open up about matters concerning their health without leaving out anything. Usually, when there is no trust between the two parties, the patient will leave out bits of information that may be very important in doing the right diagnosis. Otherwise, patient confidentiality helps to improve the quality of healthcare services because a patient will give out the right information and the right treatment plan will be used.
Patient confidentiality will help protect a patient from stigma incase they are suffering from a stigmatizing condition like reproductive or sexual. This increases the willingness of a patient to seek medical attention instead of keeping it to themselves and risking major problems. If there was no confidentiality in the medical field then most people would never come forth to talk about their deepest issues to a stranger in the name of a practitioner. So, more people get to seek medical attention and poor health is eradicated from the society. Patient confidentiality will prevent the healthcare facility and the practitioners from being sued of breaking the medical codes of ethics. If patient confidentiality is breeched, the practitioners responsible will have to face the law and suffer the consequences. Therefore, no legal actions can be taken if confidentiality is respected.
It is clear that there are more advantages of not having patient confidentiality as compared to having it in the codes of ethics. Without the confidentiality rule in healthcare, the patient will have a better chance of getting better with all the help and support he or she will get from family, friends and well-wishers (Hartigan, 2018). On the other hand, the only advantage of patient confidentiality is building trust and enabling a patient to willfully give information about their health condition. However, this can also be achieved without the issue of having patient confidentiality. Actually, family members of the patient cannot entrust you with their patient if you cannot give them information about the progress of their patient. This definitely brings a dilemma on the issue of patient confidentiality but there are more pros of not having patient confidentiality than there are in having patient confidentiality.
References
Petronio, S., Sargent, J., Andea, L., Reganis, P., & Cichocki, D. (2004). Family and Friends as Healthcare Advocates: Dilemmas of Confidentiality and Privacy. Journal of Social and Personal Relationships, 21(1), 33–52. https://doi.org/10.1177/0265407504039838Riaz, S., Khan, E. A., & Jafar, T. (2017). Ethics in health care settings: practices of healthcare professionals and perceptions of patients regarding informed consent, confidentiality and privacy at two tertiary care hospitals of Islamabad, Pakistan. Journal of Ayub Medical College Abbottabad, 29(3), 472-476.
Hosseini-Ghavam-Abad, L., Asghari, F., Bandehagh, A., Najafipour, S., & Bigdeli, S. (2019). Patient privacy: Awareness and attitudes of Iran University of Medical Sciences medical students. Medical journal of the Islamic Republic of Iran, 33, 12.
Noroozi, Mahshad, Ladannaz Zahedi, Fataneh Sadat Bathaei, and Pooneh Salari. (2018): “Challenges of confidentiality in clinical settings: compilation of an ethical guideline.” Iranian journal of public health 47, no. 875.
Hartigan, L., Cussen, L., Meaney, S., & O’Donoghue, K. (2018). Patients’ perception of privacy and confidentiality in the emergency department of a busy obstetric unit. BMC health services research, 18(1), 1-6.
