b. Patient Care. Records must be readily accessible to the health care
providers who need them in order to ensure the best possible care for the patient.
While accessibility may increase the risk of unauthorized access by others, this is a
necessary and calculated risk. There are more malpractice suits for improper care than
for unauthorized access. And, the requirement for prompt and correct care may, at
times, override the need to protect confidentiality.
c. Administrative Uses. Medical records are business records that must be
accessible to hospital staff members for billing, filing, auditing, responding to inquiries,
and defending potential legal actions (litigation).
d. Research. It is quite common to use records for research without patient
consent, as long as the records are for bona fide research. Research by non-staff
members should be subject to a hospital review and approval process, and the
identities of patients should be protected.
FORCED DONORS VS THE RIGHT TO PRIVACY
In 1988, Tomas Bosze's 12-year-old son, Jean-Pierre, was diagnosed with leukemia
after an unsuccessful attempt to find a suitable donor for a bone-marrow transplant,
Mr. Bosze approached Nancy Curran, a woman with whom he had an affair 4 years
earlier. She had since given birth to twins, Jean-Pierre's half brother and half-sister,
who would be more likely than anyone else to be compatible donors.
Bosze requested that Curran have the twins tested as possible donors. When she
refused, Bosze went to court in an attempt to force Curran to have the twins' blood
tested and, if there were a match, to let physicians "harvest their marrow."
The risk of complications from withdrawing marrow through a needle from the donor's
hipbone is relatively small. But the mother said she did not want to take that risk or
put her offspring through any undue pain. An Illinois judge denied Bosze's request,
ruling that to force a donation would be a violation of the twins right to privacy.2
LEGITIMATE NEED FOR ACCESS TO CONFIDENTIAL INFORMATION WITHIN
THE MEDICAL COMMUNITY FOR:
Figure 3-2. Information gained through the physician-patient relationship is
confidential. But, there are legitimate needs for access to such
information within the medical community.