private moments

Tuesday, December 1, 2009

It may be the most publicized fender bender known to man and the circumstances surrounding Tiger Woods’ accident remain fodder for much speculation but perhaps the lesson to be learned has to do with privacy or the lack thereof in today’s world. Public figures fight hard for private moments, but for the rest of us, privacy remains an expectation. Medical privacy is not only a given, it’s an ethical consideration and almost as importantly, it’s the law. Tiger Woods may have been care for in an emergency department after his accident, but it’s illegal for any hospital personnel to acknowledge his presence without Woods permission. And Tiger doesn’t get special treatment.

When patients present for care within the medical system they give permission to hare medical information on an as needed basis. Sometimes, it’s hard to maintain privacy and perhaps that is when it is most crucial to offer that opportunity.

Imagine being a 16 year old girl presenting to the doctor’s office with abdominal pain. A worried parent hovers nearby and may be asked to leave the room. How else to get a truthful answer about sexual activity and perhaps pregnancy? Perhaps an elderly patient needs time and space to admit that they are being abused or neglected. For these situations and in similar others, the need for privacy reigns to provide care and compassion.

A myriad of rules and laws govern the behavior of hospital workers when it comes to privacy. Worried that your friend didn’t come home at night, you call your local hospital ER and you get a stone wall. Privacy concerns may prevent acknowledging your friend’s visit. Every hospital worker from the doc to the laundry worker knows not to talk about patients in public hallways and elevators. And yet, medical records and information need to make their way from hospital to hospital. Families and friends want to know what’s going on. The key to releasing information about a diagnosis, treatment, prognosis and more mundanely, even if a visit occurred, depends upon the patient’s decision to release specific information. Some patients want everybody to know everything while others are more guarded. Each situation is unique.

In the ER, rules require that patients be asked if they feel safe at home and whether they have been victims of abuse. Reporting neglect, abuse and other crimes have mandatory legal reporting requirements.

There are safeguards to protect patient privacy but in times of crisis, rules can be bent. While unconscious or confused patients cannot give consent to release information, the implication is that they would want to get help in any way possible. Medical release forms can be waived and families can be contacted because in caring for a person, information is king. Knowing the past medical history of a patient can unlock the key as to what might be going on.

Celebrities voluntarily give up much of their private life to enjoy the benefits of their publicity, however there is often a clear delineation between their public and private lives. Private starts when the person crosses the hospital threshold.

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