Section III: CONFIDENTIALITY AND THE LAW
3-12. LEGAL RECOGNITION OF CONFIDENTIALITY
a. Which Health Care Provider Relationships Are Protected? Some states
have enacted statutes to protect the patient and bar some overriding state interest.
The physician protects the patient from disclosure of confidential communications,
except upon consent of the patient. The law and the ethical codes differ on the issue of
the confidentiality of the privileged communication. While medical codes of ethics for
health care professionals recognize confidentiality as an ethical responsibility for all
health care providers, the statutes exempting health care professionals from having to
testify about confidential disclosures vary from state to state. Different health care
providers are covered depending on the state. Some courts include one or more health
care providers, such as x-ray technologists, by implication, on the theory that they act
as agents of the physician. (The radiographer should be vigilant about protecting
information gained through x-ray reports and case notes.) Other states include nurses,
but not dentists. Still others, limit protection from the obligation to disclose to
physicians and surgeons.
ESSENTIAL ELEMENTS OF CONFIDENTIALITY
A physician-patient relationship exists.*
The information was gained within the privileged relationship.
The information was necessary and relevant to the professional treatment of the
patient.
*States vary as to which health care provider-patient relationships are protected
under the privileged communication statute.
Figure 3-4. Conditions required for a disclosure to qualify as a privileged (protected)
communication.
b. Other Medical Personnel. There are no legal decisions as to the application
of the doctrine of confidential communications to medical students, attendants,
technicians, and nonmedical employees of the hospital. But, as stated earlier, all
employees of the medical community have a moral (ethical) obligation to maintain
secrecy.
3-13. ESSENTIAL ELEMENTS OF CONFIDENTIALITY
a. The Existence of Privileged Relationship. In order for a disclosure to
qualify as a privileged communication, certain conditions have to be met. First, there
has to exist a professional (physician-patient) relationship between the two parties
involved.
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