Overview
Health Insurance Portability and Accountability Act guarantees the security of patients and confidentiality of their medical records. Healthcare centers have put in place digital methods of recording data, which is secured by encryption or by private access keys that are only known to healthcare providers to enhance security. Healthcare practitioners have appreciated medical privacy with patients taking legal actions against violation of their privacy and confidentiality. However, healthcare providers have experienced ethical dilemmas in various situations where they are torn between their code of ethics, overall welfare of patients and other concerns such as national security. Mary (a senior doctor) attended to a patient (Paul) who had been brought to the hospital with severe injuries. During her discussion with the patient, Mary discovered that Paul had acquired the injuries during a confrontation with the Central Intelligence Security and that he was a big threat to the nation. His x-ray records further revealed that he had private trackers installed on his right arm, which was supposedly meant to track his location. Mary was in a dilemma on whether to report Paul to the security officers or attend to him in accordance with the requirements of professional code of ethics. Days later after his discharge from the hospital, Paul bombed a city restaurant, killing ten and injuring many citizens.
Problem Analysis
Facts
The doctor is not supposed to disclose the patient’s medical information without his or her consent. The patient is allowed to sue any healthcare provider for breach of confidentiality. A doctor or any healthcare provider has a legal obligation to give warning against patient criminals. The breach of confidentiality tort is, however, illegal according to the common law and the HIPAA Privacy Rules.
Stakeholders
The relatives of those who died after the attack, as well as those injured as the plaintiffs in the case, brought charges against Paul, Mary and the state police for not taking appropriate action to thwart the attack. The plaintiff further alleged liability against Mary for her negligence to report Paul and the police for their inability to confine the criminal before pursuing his criminal activities. The restaurant owner accused the state police of not protecting his premises as well as his clients within his premises. However, for the best outcome for the stakeholders, it could be best if the doctor breached the confidentiality tort and reported the matter to the police. The state police should, however, be blamed for letting go a criminal whose freedom could endanger the lives of the citizens. The plaintiffs would then be reimbursed for their losses by the state government. Medical practitioners are then advised to prioritize national security and report criminals to avoid catastrophes such as the attack. Besides, Mary would have still attended to Paul even after reporting him to the police.
Consequences
Medical Privacy policies and principles
Common law, as well as the Health Insurance Portability and Accountability Act, provide laws protect patients’ information against disclosure without their consent. If there is a violation of the law, the violator is entitled to $100 to 450,000 for civil money penalty per violation. However, if the defendant is convicted of a known violation, he or she charges a fine of between $50,000 and $250,000 (Cosentino & Hess, 2013). Traditional pillars that guide medical ethics provide for the compliance of various principles. Beneficence principle requires the practitioner to promote the patient towards what he or she terms as his best. The practitioner should thus further practice the principle of non-maleficence where he or she is not supposed to harm the patient or engage in actions that could harm the patient (Singh & Ivory, 2015). It is further the individual’s responsibility to secure the rights of others, especially by protecting the right of privacy by not disclosing patients’ personal information.
Possible solutions
Various solutions could be identified in Mary and Paul’s case. In the first decision, Paul is responsible for violating common law by causing harm to individuals and charged under criminal law. Paul could face detention or be incarcerated in a rehabilitation center depending on the courts’ decisions (Ashworth & Horder, 2013). The state police would be let free since they tried within their means to get hold of the criminal, but he managed to escape. Mary would be let free since she practiced the medical ethics by not disclosing her client’s details to the state police although they could be helpful to the state. It is within her consent to choose between what is right and what is wrong but most importantly; refrain from breaching the tort of confidentiality. Secondly, the court could hold responsible two of the defendants for the liability caused. For Paul, his jurisdiction could be in agreement with the common law against criminals. Mary could be held responsible for not disclosing Paul’s security records to the relevant laws. HIPAA provides various exceptions to the confidentiality rights of the patients. In the exceptions, the practitioner may disclose the patients’ information voluntary for the nation’s security. The latter may or may not involve government interventions, and the healthcare provider should not be forced or coerced to disclose such information. However, she should have disclosed the matter for law enforcement and should be held liable for negligence (Earp & Payton, 2015).
Decisions Review
In the final decision, Paul would be held responsible for the liability caused. On the hand, the state security officers would not be held liable since they were in their line of duty in getting hold of the criminal. Concurrently, Mary would not be held responsible since the law provides that they can present the information for national security voluntarily. The decisions could be justified by others since they are rational decisions that are justified to all stakeholders.
Results Evaluation
The outcome achieved the desired results since medical practitioners have been guaranteed the duty to warn of various dangers that could be caused by their patients. However, the actions could be done in a rightful manner to protect the patient against the anger of the public. Criminal activities have declined through the help of healthcare providers who report criminals for the national security. In addition, reporting the criminals does not imply that they will not receive medical attention.
Ethical Theory
The ethical theory that supports the above decision is the theory of altruism. In theory, the interests of others are considered in preference to individual interests. In the above case, medical practitioners should practice altruism by preceding their medical ethics and reporting criminal activities for the interest of the public and the nation as a whole.
References
Ashworth, A., & Horder, J. (2013). Principles of criminal law. Oxford University Press.
Cosentino, S., & Hess, R. (2013). Safeguarding Your HIPAA and Personal Health Information Data.
Earp, J. B., & Payton, F. C. (2015). Privacy of Medical Records: IT Implications of HIPAA.
Singh, J. P., & Ivory, M. (2015). Beneficence/Nonmaleficence. The Encyclopedia of Clinical Psychology.
