Patient Confidentiality
... nurses, therapists, nutritionists, pharmacists, medical students, secretaries, chart reviewers, financial employees, chaplains, social workers, etc. Most, if not all, of these workers are necessary to obtain the best possible care. The fact that so many people have access to personal files makes patients very uneasy and can potentially interfere with patient care. Another problem with protecting patient confidentiality is the fact that as more and more workers have access to patient information, the risk of irresponsible use of this information goes up. Siegler points out that confidential information is sometimes exchanged between workers in places such as elevators, cafeterias, doctors’ offices, and break rooms. This is a violation in the medical code of ethics, but it does happen in the workplace. This can become a larger problem when information is learned about someone a worker knows. This can lead to further violation of privacy because people the patient do not want knowing their private issues now know. As medical technology has become more advanced, computers now hold lots of information about patients. This means that anyone with the right equipment and passwords can access patient files. It is a dangerous thought to know that even though we have made efforts to make unauthorized access more difficult, it is still very much up to employees to keep this information private. I worked in the medical records department of a hospital for two years. Everyday I dealt with keeping information private. It amazed me how easy it was to obtain information about patients. If I wanted to I could find out everything from their medical history to procedures done, to medications prescribed. I could even access files from other hospitals. This could all be done with a valid username and a simple password. This means that anyone that works in the hospital has the same access I did. Personally, that is very disturbing. It seems very unethical to me that as a patient, our most private information is so easily accessed by so many people. I do have to give some credit to our efforts to maintain confidentiality. We did follow many rules and procedures in order to keep private information out of the wrong hands. Some of these rules require that we see a picture ID and fill out a Record Release Form in order to allow a patient’s information to be released. One last problem with patient confidentiality stems from the physician’s obligation by law to report certain issues. Issues dealing with STD’s and gunshot wounds are examples of cases that must be reported to the Health Department or other authorities. Sometimes a physician can use his own discretion in whether or not to report a case depending on the issues involved. There are questions to whether or not this is ethical though. If this information is not reported, there are possible health and safety risks involved. When medical information is shared with so many people, the patient’s autonomy is violated. In order to obtain the best care possible, patients cannot keep a lot of this information from being revealed. It is necessary for most of these workers to know as much as they can about a patient in order to successfully treat them. But, for the most part, the patient does not have any say in which workers see their file. This is a violation in patient autonomy that cannot be easily fixed. Informed consent is another area violated be the release of patient information. Even if a patient fully understands the problem and treatment, they may not understand how many people are involved and have access to their records. When a patient gives informed consent, they are not told exactly who will see their private information. This would take too long and could possibly cause the patient to deny treatment. But is this information not part of informed consent? Is it not the patient’s right to know this information? So, when a patient gives informed consent, are they truly informed? Siegler offers many suggestions to the confidentiality problem. First of all, he suggests that in settings where many people have opportunities to view the record, ...