Truthfulness and Confidentiality, Ch. 5

HIPAA (1996)Health Insurance Portability and

Accountability ActEffort to codify and give national conformity

to the use of confidential patient information

Statutory Disclosure:HIPAA reinforces legal requirements to release

information regarding:Venereal diseasePoisoningsIndustrial accidents

Statutory Disclosure (cont.):AbortionsDrug abuseAbuse of

Childrenthe Elderlythe Disabled

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

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

Tatiana Tarasoff

Prosenjit Poddar

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

FamilyNeighborsAnyone physically intimate with patient

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

Patient Access to Medical RecordsHIPAA 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

Breach of Confidentiality:Simply note that courts do award cash to victims

whose medical secrets are exposed viaOralWrittenComputer communicationThe legal basis can beStatutes defining expected conductEthical duties owed to patientBreach of fiduciary dutiesBreach of contract or implied contract between

doctor and patient

Defamation:“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 slanderWritten defamation is libelStandard of legal liability is

negligenceHarm must be demonstrated

to succeed in a claim of defamation

Defamation (cont.):The requirement to demonstrate harm is satisfied

without need for additional information in these cases:

Criminal activityAIDSVenereal diseaseBusiness, trade, or professional misdeed, orUnchastitySuch cases are calledSlander per seLibel per se(per se means by themselves)