Administrative Ethics Paper

Administrative Ethics Paper

Steven Tijerina
HCS 335 Health Care Ethics and Social Responsibility
September 1, 2013
James Dockins

Administrative Ethics Paper

Administrative Ethics Paper

Health Insurance Portability and Accountability Act Privacy passed by the United States
Congress into law in 1996. HIPAA established security protocols and breach notification rules
for medical practitioners to follow when protecting the patients private health information.
Congress enacted HIPAA to guarantee the protection of confidential patient health care
information HIPAA also addresses the patients need for privacy. The entities most affected by
HIPAA regulations include health care providers, health plan providers, such as Blue Cross Blue
Shield or government funded insurance programs like Medicare or Medicaid, and health care
clearing houses. The Department of Health and Human Services states that the Office for Civil
Rights enforces the HIPAA Privacy Rule, which protects the privacy of individually identifiable
health information; the HIPAA Security Rule, which sets national standards for the security of
electronic protected health information; the HIPAA Breach Notification Rule, which requires
covered entities and business associates to provide notification following a breach of unsecured
protected health information; and the confidentiality provisions of the Patient Safety Rule, which
protect identifiable information being used to analyze patient safety events and improve patient
safety (Department of Health and Human Services).
The American Medical Association states confidentially between a patient-physician are
of the highest importance, especially to the doctor establishing the relationship with the patient.
Confidentiality is an unspoken understanding that clinicians and medical practitioners must
honor and uphold.

The American Medical Association Code of Medical Ethics states the

Administrative Ethics Paper

clinicians should keep patient health information private unless the patient expresses his or her
consent authorizing the release of the information to the specified parties. The exception to the
rule of patient privacy does not apply to clinicians required to inform authorities when the patient
threatens bodily harm to himself or to another person. The Hippocratic Oath, which dates back
to fifth century, reads I will respect the privacy of my patients, for their problems are not
disclosed to me that the world may know. Clinicians and medical practitioners must uphold their
Hippocratic Oath; however, but this is not always the case. Many medical practitioners believe
that accessibility to medical records is essential to providing the best care for the patient, whereas
others argue that with the increase of electronic records more patients risk the confidentiality of
his or her private medical records. Part of the risk of transferring electronic medical records is
easy accessibility. Medical practitioners generally uphold the highest degree of privacy
concerning confidentiality; however, ethical, and legal regulations ensure entities respect the
patients right to maintain his or her medical records private.
The ethical considerations frequently associated with patient confidentiality include
respecting patient autonomy, the implied promise of doctor-patient confidentiality, the use of
virtue ethics by doctors to make decisions regarding confidentiality, and consequentialism, which
demonstrates that doctors who breach confidentiality often lose patients trust. Consequentialism
proves that not disclosing patient information to third parties may be detrimental to a patients
health because certain information about previous treatment is not disclosed from doctor to
doctor. Autonomy acknowledges the right of the patient to have control over what persons or
third parties have access to his or her medical records. Doctors-patient confidentiality is the
basis of which a patient openly confides in his or her doctor on the grounds of maintaining the

Administrative Ethics Paper

disclosed information strictly confidential. Patients will not openly disclose information to
physicians if the patient believed the doctor would breach the confidentiality of private
information that patients voluntarily disclose to health care providers. Through virtue ethics
doctors can predetermine what confidential information to disclose or not disclose as so long as
disclosing the information benefits the patient. A doctor would not violate the patients right to
privacy by disclosing information about the patients illness or treatments to immediate family
members or friends.

This is true even when the patient did not agree to the disclosure of

information because ultimately informing family member is in the patients best interest.
Health care practitioners must adhere to HIPAA regulations concerning patient privacy,
the access to medical records, and the disclosure of a patients health care information.
Managers must limit the access to patient health information and the disclosure of information
among medical professionals remains limited to the amount necessary to provide the best
medical care. Communication between doctors and patients is confidential unless the clinician
must furnish information in accordance to state and federal laws or regulations. For cases in
which the patients condition threatens public health the clinician must report the information
about infectious diseases, such as tuberculosis, syphilis, or HIV/AIDS to state and local public
health agencies. Doctors must also report suspected signs of child abuse, adult abuse, or abuse
of the elderly to Child Protective Services and Adult Protective Services agencies. Patients can
address privacy practices complaints with the Office of Civil Rights or directly with the health
care provider. Health care practitioners regularly should disclose privacy practices about the use
of patients medical records within those establishments. Health care providers cannot disclose
patient medical records for reasons, such as marketing. Health care providers must also permit

Administrative Ethics Paper

patients to obtain copies of his or her medical records this includes correcting errors on medical
records. The managerial responsibility related to administrative ethical issues of every health
care practitioner remains the duty to maintaining patient medical records confidential and
private.
The legal considerations frequently observed with patient confidentiality include statutes
or regulations that require health care practitioners disclose confidential information in certain
cases that would otherwise breach doctor-patient confidentiality. The exceptions of patient
confidentiality for physicians include the disclosure of medical records to a state or federal judge
as part of a criminal investigation.

Doctors must immediately contact police with any

information furnished by patients, which prevents acts of terrorism. The Department of Motor
Vehicles requires doctors disclose information about a persons medical conditions or disability
that impair the person ability to operate a motor vehicle. Doctors must disclose information to
state or local health department agencies when public health in threatened by the spread of
infectious diseases.

The solution I propose for solving ethical and legal issues affecting

confidentiality and patient privacy in the delivery of health care in the United States begins with
focusing on the best interest of patients. For patients to provide a complete disclosure of
information doctors must avoid breaching the patients trust. Confidentiality encourages patients
to speak honestly and openly with health care providers when addressing health concerns or
treatment options. Patients must completely disclose information to their doctors this helps the
doctor determine the best treatment options. Clinicians must uphold the Hippocratic Oath
because it provides an assurance that statements made by a patient to a doctor remain
confidential.

Administrative Ethics Paper

References

Health Care Ethics. Principles and Problems, Fifth Edition (2010)

Thomas M. Garrett , Harold W. Baillie , John F. McGeehan , Rosellen M. Garrett

The Merck Manual Home Health Handbook, Confidentiality and HIPAA

Retrieved from
http://www.merckmanuals.com/home/fundamentals/legal_and_ethical_issues/confidential
ity_and_hipaa.html?qt=&sc=&alt= on August 31, 2013

Department of Health and Human Services, Health Information Privacy

Retrieved from www.hhs.gov/ocr/privacy/index.html on August 31, 2013

American College of Health Care Executives, Health Information Confidentiality (2012)

Retrieved from http://www.ache.org/policy/hiconf.cfm on September 1st, 2013