Medical privacy
Medical privacy refers to the right of individuals to control the disclosure and accessibility of their personal health information. This concept is underscored by the understanding that certain medical details are sensitive and should remain confidential unless the individual decides otherwise. Across different cultures, perceptions of medical privacy may vary, but there is a common recognition of its ethical significance, often protected by laws and regulations. In the United States, legislative measures like the Health Insurance Portability and Accountability Act (HIPAA) establish clear guidelines for safeguarding patient information and outline patients' rights regarding their medical records.
The importance of medical privacy has come to the forefront particularly during public health crises, such as the HIV/AIDS epidemic, where the implications of disclosing sensitive health information can lead to discrimination and social stigma. Organizations managing medical records must adhere to strict protocols for information gathering, storage, and sharing, balancing the need for health information accessibility against the individual's right to privacy. Recent advancements in technology and the prevalence of electronic medical records have heightened concerns about data breaches, prompting calls for robust privacy protections. Ultimately, effective medical privacy management is increasingly viewed as a vital ethical responsibility for both healthcare providers and organizations involved in handling personal health data.
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Medical privacy
The concept of privacy has long existed in academic, legal, and political spheres, yet there is no universal definition for it. Notions of privacy vary across cultures, although there are some general commonalities. It is usually understood that information is private when it is inherently sensitive and when the owner of the information wishes to keep it undisclosed, often for security reasons.
In most modern cultures, the idea of privacy has an ethical component. Many societies advocate the right to be protected from invasion of privacy by others, be they governments, employers, or businesses, and the protection of privacy is part of the legislature and even the constitution in many countries. As technology increases the amount of available information, disclosing medical information is one of the areas that raise a host of legal and ethical issues.
Background
The concept of privacy has long historical roots. Discussions in ancient Greek philosophy sought to define the demarcation between the public sphere of politics and the private sphere of household and family life. The concept of legal protection of personal privacy emerged in the United States in 1890, when Louis Brandeis and Samuel Warren published their seminal article “The Right to Privacy” in the Harvard Law Review. The issue grew in importance in the second half of the twentieth century, as privacy protection in the law evolved. In the early 1960s, privacy rights protections were determined to cover intrusion on a person’s private affairs and seclusion as well as public disclosure of embarrassing facts about a person.
Almost all modern nations have laws that both protect and limit privacy to different extents. One of the contemporary issues that brought medical privacy rights to the forefront was the HIV/AIDS crisis. Disclosing an HIV-positive diagnosis is a decision mired in difficulty. In many cultures, having an HIV diagnosis puts a person at risk of institutional discrimination in such areas as employment and housing, in addition to social exclusion and personal distress. Because HIV can be propagated by actions such as blood transfusions and intimate person-to-person contact, issues of public health and safety versus privacy rights became a hot topic of discussion. Notions of privacy and public disclosure bring together several significant ideas: the right to privacy, the circumstances under which disclosure is a duty, and the social consequences of disclosure of personal health information in the medical field. These ideas are relevant not only in public policy but also in privacy management in organizations and corporations.
Public policy and legislators have sought to balance the right to privacy and voluntary disclosure with the need for coerced or public disclosure. For example, personal health information provided to medical staff is shared with pharmacies, insurance companies, researchers, and other pertinent staff and providers, but the ways in which that information is shared and safeguarded are based on specific regulations created to protect privacy rights. The privacy of health records is protected in the United States by federal law through various legislative measures.
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Several US legislative measures define patients’ rights over their information and set limitations on who is allowed access to this information. Some important measures are the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Patient Safety and Quality Improvement Act of 2005 (PSQIA).
HIPAA has several parts. The HIPAA Privacy Rule protects the privacy of individual’s health information, the Security Rule sets security standards for electronic information, and the Enforcement Rule establishes procedures for investigating violations and penalties for confirmed violations. The Breach Notification Rule, introduced in 2009, mandates that institutions provide notification in case of a breach of protected health information.
The PSQIA was created to improve patient safety. It encourages confidential voluntary disclosure of events that may affect patients adversely. Medical providers often worry that these disclosures might be used against them in cases of disciplinary processes and medical malpractice. The PSQIA takes these concerns into consideration and provides legal confidentiality protections to information disclosed by providers. It also establishes limitations on the use of the information in criminal and civil proceedings. Finally, it established a national network of patient safety databases for use by providers and other organizations that includes valuable information such as national patterns of patient safety.
Another important legislative measure is the American Recovery and Reinvestment Act of 2009 (ARRA), which, among other provisions, calls for the use of electronic medical records by medical providers and hospitals. According to several studies, many Americans worry that their medical information is not sufficiently protected. In response to these fears, the ARRA introduces significant measures designed to protect patient privacy in the United States, including giving patients the right to review their medical files, correct erroneous information, and block unauthorized access to their information.
The increasing accessibility of digitally stored information is a global concern. Frequent breaches of secured databases at national and international levels increase public fears, while traffic of personal information databases, both legitimate and illegitimate, has often proven hard to control. In both public and private organizations, the concept of privacy usually relates directly to private information-management practices of the organization and the processing of this information through all the systems’ cycles. For an organization, this involves processes such as information gathering, storing, disclosing, and deleting. At the individual level, it means managing information such as addresses, phone numbers, personal and financial transactions, Internet usage, and medical records. It may take years for an organization or individual to build up this information.
The most valuable intangible asset organizations have is trust. Because the consequences of breaching this trust may have long-term consequences for organizations, individuals, and the public at large, privacy management has increasingly been considered an ethical responsibility.
Bibliography
Alderman, Ellen, and Caroline Kennedy. The Right to Privacy. New York: Vintage, 1997. Print.
American Medical Association. Code of Medical Ethics of the American Medical Association: Current Opinions with Annotations. 2012–13 ed. Chicago: AMA, 2012. Print.
Cahn, Steven M., and Peter Markie. Ethics: History, Theory, and Contemporary Issues. 5th ed. New York: Oxford UP, 2012. Print.
Dennis, Jill Callahan. Privacy: The Impact of ARRA, HITECH, and Other Policy Initiatives. Chicago: Amer. Health Information Mgmt., 2010. Print.
Lowrance, William W. Privacy, Confidentiality, and Health Research. Cambridge: Cambridge UP, 2013. Print.
Marcella, Albert J., Jr., and Carol Stucki. Privacy Handbook: Guidelines, Exposures, Policy Implementation, and International Issues. Hoboken: Wiley, 2003. Print.
Smith, Robert Ellis. Compilation of State and Federal Privacy Laws.2013 ed. Providence: Privacy Journal, 2013. Print.
Solove, Daniel J., and Paul M. Schwartz. Privacy Law Fundamentals. 2nd ed. Portsmouth: Intl. Assn. of Privacy Professionals, 2013. Print.
United States. Cong. House. Subcommittee on Government Management, Information, and Technology of the Committee on Government Reform and Oversight. Protecting Health Information: Legislative Options for Medical Privacy. 105th Cong., 2nd sess. Washington: GPO, 1999. Print.
United States. Cong. House. Subcommittee on Health of the Committee on Energy and Commerce. Assessing HIPAA: How Federal Medical Record Privacy Regulations Can Be Improved. 107th Cong., 1st sess. Washington: GPO, 2001. Print.