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Insurance Portability and Accountability Act HIPAA of 1996 (HIPAA).
A. Why are People Worried about Medical Privacy?
"What I may see or hear in the course of the treatment or even outside of the treatment
in regard to the life of men, which on no account one must spread abroad, I will keep
to myself, holding such things shameful to be spoken about."
This quote from the Hippocratic Oath, which is traced back to ancient Greek medicine,
shows that medical privacy is not a new idea. Physicians were expected to keep
secrets, but there was little public concern because, as discussed earlier, medical care
was much simpler so there was less information to worry about and few people
handling it so there was little chance of the patient's privacy being breached. As
discussed above, after World War II, medical care changed from simple care given by
physicians to hospital- based team care. This change made medical care less personal
and much more threatening. At the same time, the civil rights movement caught up to
medicine.
In the 1960s and 1970s, patients started demanding a say in their medical care.
Physicians were pressured to end the practice of hiding cancer and other fatal illnesses
for patients. While this was a common practice, there was overwhelming evidence that
patients wanted to be told about their illnesses and did better when they were told.
Lying to patients about their condition also meant telling family members and
sometimes others about the patient's medical condition, while withholding this
information from the patient. This created tension between family members and the
patient because the family members believed that had to follow the physician's advice
and lie to the patient. Patients started demanding access to their medical records so
they would know what was being done to them and why. The main concern was
controlling care. Access to information and its control were important as they related to
the care.
While there were many factors that lead to today's concerns with medical privacy, the
single most important factors was acquired immunosuppression syndrome (AIDS) and
its, cause human immunodeficiency virus (HIV) infection. In 1981, the first cases of
AIDS were identified. It was suspected to be an infectious disease before its method of
transmission was worked out. This lead to public fear of being in contact with persons
with AIDS, a fear that was mixed with discrimination because AIDS started as a
disease of gay men and drug addicts. There were many anecdotes about gay men being
fired from their jobs or losing their apartments because they had AIDS or were feared
to have AIDS. AIDS support organizations and civil liberties groups such as the ACLU
starting looking harder at medical privacy and publicizing the potential consequences
of having employers, landlords, and others learn about frightening medical conditions
such as AIDS and cancer. It was also not unusual for persons with other serious or
disabling illnesses to lose their jobs because their employers were afraid of increased
health insurance costs and lower productivity.
AIDS advocacy groups pushed the issue of medical privacy beyond concerns with the
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