Patients deserve right to maintain privacy

  David Rigsby Rigsby is a second-year
political science student who thinks that everyone deserves privacy
““ even celebrities. You can e-mail him at [email protected]. Click
Here for more articles by David Rigsby

The writers of the NBC drama “ER” follow very simple
formulas when they create scenes involving doctor-patient
interactions. A classic example of one of their cookie-cut scenes
plays out as follows: a very nervous Patient X comes in to the ER
at Cook County General and is examined by Dr. Y. Dr. Y suspects
that the patient is hiding some symptom that will alter the
diagnosis, so he or she uses the classic line, “Anything you
tell me is just between us, unless there is something illegal
involved.” Patient X trusts Dr. Y’s warm glow and tells
them some personal piece of information. Dr. Y changes the
diagnosis and saves the day in the name of doctor-patient
confidentiality. Just another day in the ER.

Unfortunately, much to my dismay, life is more complex than
television. Things are not as cut and dried as they are
Thursday nights at 10 p.m. Doctor-patient confidentiality only
goes so far. By this I do not mean that you should fear that your
doctor will “share” your personal medical information
with his buddies. Patients should be concerned with the
growing number of parties that have, or will have, instant access
to their medical records.

The medical industry in this country is moving toward a shift in
fundamental values. Medical researchers are making incredible
progress with genetic research and miracle drugs by using large
amounts of patient data. At the same time, individuals grow wearier
by the day about the use of their medical records in the dawning
Information Age.

In recent years, voters have been putting the squeeze on
government officials by demanding that they develop a set of
guidelines concerning medical record privacy. The issue can no
longer be avoided on a federal level.

  Illustration by ERICA PINTO/Daily Bruin There is no
comprehensive federal law that protects the privacy of individual
medical records. Privacy issues have generally been lumped into
those reserved for states to deal with, but as information crosses
state lines, there comes a time for Washington to step in. There
are various state laws on the books, making medical record privacy
an exception, not a rule.

Two competing interests, both with valid arguments, have already
started to wage war against one another. On one side are the
research teams that depend on medical information in order to
develop new life-saving drugs and technologies. On the other side,
however, stand patients who value confidentiality with their
doctors.

The issue has recently heated up by controversial legislation
passed in the final weeks of the Clinton administration. The
regulations require that health care providers obtain written
consent from patients for the use or disclosure of information in
their medical records. The secretary of health and human services
drafted the new rules, which will affect the way that all future
medical projects are conducted. The New York Times reported on Feb.
11 that the health care industry is lobbying the Bush
administration to, “delay, change or kill the
regulations.” The Bush administration is now taking steps to
“revise” the regulations that were originally scheduled
to take effect on Feb. 26.

If the rules go into effect, health care providers will be
required to create the position of “privacy official”
to develop privacy policies and procedures. Patients will have the
opportunity to demand that their health care provider tell them of
all disclosures of information that have occurred in the last six
years. Penalties for health care givers who do not abide by the new
regulations range from a $250,000 fine to ten years in prison if
the offense was committed for “commercial
advantage.”

Medical research teams, pharmaceutical companies and other
organizations have compelling arguments for why they need easy
access to information. Many people, especially those with
disabilities and life-threatening diseases, rely heavily on
biomedical research.

The New York Times reports that, “Hospitals, insurance
companies, health maintenance organizations and medical researchers
said the rules…would impose costly burdens.” Critics say
that the Clinton administration went too far in the regulations
calling them, “too restrictive and, in many ways,
unworkable.” John P. Houston, a lawyer at the UPMC Health
System, said that new rules, “could impede patient care and
disrupt essential operations” of hospitals.

Historically, medical records were used primarily by doctors and
medical insurers. With the surge in electronic record keeping,
however, the amount of parties with access to medical record
databases has increased dramatically. The general concern of the
public is the potential amount of misuse of their medical
information. Christopher J. Dodd, D-Conn., said, “The public
cares about this issue very, very much.” For the first time
under proposed regulations, individuals will have the right to
access their own health information and the right to amend such
information.

The medical industry argues that if given a choice, many
patients will opt not to allow their medical information to be used
in studies that could potentially have life-saving effects. The
public argues that unless the privacy of patients is protected,
many patients will opt not to share details of their medical
condition with their doctors, hoping to keep the information off of
their medical records. And by not giving their doctors all of the
facts, patients will ultimately harm their chances of successful
treatment. Patients should feel safe by giving their doctors all
the facts and at the same time understand that their information
can be used to help mankind.

Both sides of the issue deserve credit for having a genuine
concern for patient care and well-being, which makes it difficult
choosing a position on the issue. It is a delicate time for all
issues of privacy, and this merits that steps be taken by the
federal government to preserve all forms of privacy. In a society
where people are giving up their privacy piece by piece, the
federal government must take an active role in protecting the
privacy of its citizens.

Privacy issues were once thought to be a state-level problem
that should be addressed by state-level solutions. The federal
government once made decisions to take on civil rights and
environmental issues, and now the time has come for a aggressive
action safekeeping the individual’s right to privacy.

The new legislation sets a standard and a starting point for
states to make further regulations and restrictions on the use of
personally identifiable medical information. Yet, it might be a
little ambitious at this time. According to the New York Times,
pharmacists are concerned about how they are to obtain consent from
a patient whose doctor phones in a prescription to be picked up by
a neighbor or a relative. Releasing a prescription to someone other
than the patient without their consent is a violation in the
proposed policy. This is just one of many technical loopholes that
make the new regulations impractical.

Hopefully the Bush administration will keep the intent, or the
“spirit,” of the regulations intact, while alleviating
hospitals from some of the heavy demands that they impose.
Sometimes smaller, and more cautious steps are preferable when the
issue at hand is one of monumental proportions. The trick will be
in securing patients of their rights without compromising the high
level of hospital care, or the efforts of valiant medical research
teams.