Ch. 9, Confidentiality and Informed Consent

defined as written instructions recognized under the law such as living wills or durable power of attorney for health care, that relate to the kind of health the patient wishes to have or not have when incapacitated

the obligation of the health care provider to maintain patient information in a manner that will not permit dissemination beyond the health care provider. The Hippocratic Oath has served as the foundation of the current medical professions' guidelines on the confidentiality of health information.

for health care is a document that allows a competent patient to name someone else to make health care decisions in the event the patient becomes incapacitated or unable to make personal decisions when certain conditions are met.

legal authority for a minor to give consent include marriage, childbirth, or entry into the armed forces. Examples of special medical conditions include pregnancy, STDs, and substance abuse.

standards of conduct issued by professional organizations to guide their members' future course of action (example the AMA determined more than two decades ago that the medical profession's obligation to maintain confidentiality of an individual's HIV status does not cease upon the death of the individual.)

is of the patient, in the form of verbal or written informed consent , is necessary in cases where diagnostic or therapeutic procedures will be performed. Examples include invasive surgery, radiological therapy, or procedures the may change the body structure

exists in situations in which a patient voluntarily submits to a procedure with apparent knowledge of that procedure and the procedure presents slight or no apparent risk, such as taking the patient's pulse or temperature. In these instances, the law presumes the patient has given consent.

providing information to patients needed to decide for or against treatment; autonomy is embedded in the concept of informed consent; ta separate legal theory, informed consent is also a process that entails not only the discussion between health care provider and patient, but physical evidence that this discussion took place and the results of that discussion

a document, exercised while a patient is competent, that provides direction as to medical care in the event the patient becomes incapacitated or unable to make personal decisions. It will generally refer to a document that provides direction as to medical care.

generally apply to records held by state agency and correspond with the principles of FOIA: a presumption of disclosure absent a statutory exemption

applies to the introduction of evidence at trial and is used to prevent the forced disclosure or testimony about information obtained by the health care provider during the course of treatment.

the right to be left alone; the legal protections for patient-specific health information is the patient's right to privacy; right to control personal information; right belongs to patient; patient protecting their own information

generally correspond with the principles of the Privacy Act: a presumption of confidentiality,which my be rebutted with evidence of patient authorization to disclose information. Privacy statutes at the state level may impose fines upon health care facilities that breach confidentiality and allow for fines to be assessed for each unauthorized access to confidential patient information.

this standard measures what a reasonable health care provider under the same or similar circumstances would disclose; expert testimony would be required to establish the parameters of the standard.

measures what material information is necessary for an average, reasonable patient to reach a decision to consent to or forgo treatment.

the process allows a health care provider to provide treatment to the patient when the patient cannot provide consent to treatment

Constitutional Provisions, Statutory Provisions, and Common Law Provisions; right to privacy is recognized but not explicitly listed in the US constitution

protect information and ensure that patient's needs are met

Freedom of Information Act; mandates access to records and disclosure upon request

Information containing identifiers by which an individual can be recognized is considered protected health information

Presume certain information held by government is confidential and individual consent needed for disclosure; impact of health care is SSA and DHHS hold information related to research and statistical studies, agencies must comply with statutes when releasing information; patient's identification removed

open record statutes: correspond with principles of FOIA, privacy statutes: correspond with federal Privacy Act, and physician-patient privilege: applies to introduction at trial, prevents forced disclosure of information obtained during treatment

Name All address information Dates, including birth, death, admission, discharge, and date indicating age Telephone numbers Fax numbers Email addresses Social Security Health record number Health plan beneficiary number Account numbers Certificate/license numbers Vehicle identifies Device identifiers and serial numbers URL's IP addresses Biometric identifiers Facial photographs Any other unique identifying number, characteristic, or code

is judge made law

invasion of privacy claims, defamation, breech of contract

statement in privacy document that states you use the information and have to share it with insurance, nurses, doctors for payment and to further your treatment

Federal Education Rights and Privacy Act

being able to show evidence of the informed consent process in an EHR is just as essential as it is in a paper based record

the patient and the patient alone who decides whether to consent to or forgo treatment if the patient is competent under the law to consent to treatment and that an emergency situation is not present. Adult patients are presumed competent absent an adjudication of incompetency by a court of law

Patient Self-Determination Act came about due to a case of Cruzan v. Director, MO Department of Health focused on the so-called "right to die" issue. The goal of the PSDA is "to ensure that a patient's rights to self-determination in health care decisions be communicated and protected." It requires those health care providers who are Medicare and Medicaid certified to inform their patients of the status of state law governing a patient's right to make advance directives for accepting or refusing health care services and the health care provider's written policies concerning implementation of the patient's rights.

legal protections to protect health care providers, other rescuers, and private citizens from liability for unauthorized treatment, as opposed to protection from rendering negligent treatment or intentional misconduct.