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Legal Issues. Truthfulness and Confidentiality, Ch. 5. Confidentiality. HIPAA (1996) H ealth I nsurance P ortability and A ccountability A ct Effort to codify and give national conformity to the use of confidential patient information Statutory Disclosure:

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legal issues

Legal Issues

Truthfulness and Confidentiality, Ch. 5


HIPAA (1996)

  • Health Insurance Portability and Accountability Act
  • Effort to codify and give national conformity to the use of confidential patient information

Statutory Disclosure:

HIPAA reinforces legal requirements to release information regarding:

  • Venereal disease
  • Poisonings
  • Industrial accidents
statutory disclosure
Statutory Disclosure

Statutory Disclosure (cont.):

  • Abortions
  • Drug abuse
  • Abuse of
    • Children
    • the Elderly
    • the Disabled

These legal duties to disclose may extend to imagining professionals, state to state. Check with your employer’s risk manager

duty to warn
Duty to Warn

Tatiana Tarasoff

Prosenjit Poddar

Duty to Warn Third Parties:

Read both scenarios on p105

Regarding Tarasoff case:

  • The duty to warn an endangered third party requires that the party is specifically identified (no duty to warn everyone someone knows who sounds violent)
  • The duty to warn an endangered third party is called a Tarasoff duty
  • Only Texas and Virginia have rejected the Tarasoff duty
  • Some jurisdictions have expanded the duty to warn beyond those specifically identified by the would-be assailant
duty to warn1
Duty to Warn

Duty to Warn Third Parties (cont.):

Note the discussion, final paragraph, of the imagining professional’s potential duties to warn third parties of contagious disease threats of

  • Family
  • Neighbors
  • Anyone physically intimate with patient

Again, imagining professionals have to check with employer policies in place; note the AIDS discussion on p107

patient access to records
Patient Access to Records

Patient Access to Medical Records

  • HIPAA has extended the rights of patients to view what you write about them
  • Some exceptions to that right to their own medical records exist, depending on jurisdiction (some do not have the right to notes taken in anticipation of a lawsuit, for instance)
  • Parents generally have the right to view the medical records of their children
torts and confidentiality
Torts and Confidentiality

Breach of Confidentiality:

Simply note that courts do award cash to victims whose medical secrets are exposed via

  • Oral
  • Written
  • Computer communication

The legal basis can be

  • Statutes defining expected conduct
  • Ethical duties owed to patient
  • Breach of fiduciary duties
  • Breach of contract or implied contract between doctor and patient
torts and confidentiality1
Torts and Confidentiality


“A tort of defamation is based on the right to maintain a good reputation.” p109

  • Defamation can only be claimed if the statement that defames is false
  • Oral defamation is slander
  • Written defamation is libel
  • Standard of legal liability is negligence
  • Harm must be demonstrated to succeed in a claim of defamation
torts and confidentiality2
Torts and Confidentiality

Defamation (cont.):

The requirement to demonstrate harm is satisfied without need for additional information in these cases:

  • Criminal activity
  • AIDS
  • Venereal disease
  • Business, trade, or professional misdeed, or
  • Unchastity

Such cases are called

  • Slander per se
  • Libel per se

(per se means by themselves)