Public Health Law Map - Beta 5 - Medical and Public Health Law Site

and if the patient is the victim of a gunshot or other potentially criminal injury, the
police will be notified. Certain cancers and other epidemiologically significant diseases
will be reported to state or national disease registries.
It is clear that even when this system works perfectly, patients only have a qualified
right to privacy in their medical information. If everyone in the system is careful only
to use the patient's information correctly and only to share with properly authorized
persons, parts of the information may still be seen hundreds of people. More critically,
most of those people need to see the information if the patient is to receive quality
medical care. Increasing the protection of records and the paperwork necessary to use
them can delay patient care and increased the cost of care. This system is not perfect,
but given the millions of pieces medical information generated every day, there are
very few improper uses or releases of patient medical information. Yet medical privacy
is a major political issue because patients, advocacy groups, and even the U.S.
Congress believes that patient privacy is being violated and that this must be stopped.
E. 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
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