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

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
unauthorized release of private medical information. The issue because preventing the
discovery of a patient's HIV status, and, if the patient knew he was HIV positive,
keeping the information out the patient's medical records and even keeping the
information from the patient's physician. As discussed in the section on Public Health,
this had a profound effect on public health practice and research. Medical privacy soon
became a general patient's rights issue and not just a concern for persons with AIDS.
The fear was discrimination in the workplace and the loss of health insurance.
Workplace discrimination was a real problem related to medical privacy and lead to
the passage of the Americans with Disabilities Act, which is discussed later in this
section. Although fears about having losing one's medical insurance were used to drive
medical privacy laws, insurability is not really a privacy issue.
People with individual, as opposed to group, medical insurance policies often lose their
insurance if they develop a chronic disease. People with chronic diseases who are
uninsured, or whose employers quit offering group medical insurance, have a lot of
trouble finding coverage, and when they do it is very expensive. Until fairly recently,
persons with chronic illness who were covered by group insurance could have
coverage for their illness excluded from coverage if they changed employers. Many
people saw this as a privacy problem that could be solved if they just had stronger
privacy laws to protect medical information.
F. Controlling Access to Your Medical Records
Until the HIPAA privacy rules went into effect, privacy and access to medical records
was mostly controlled by state law. There was a federal law that protects alcohol and
substance abuse treatment records from disclosure without out the patient's permission
and limits the use of these records in court without the patient's permission.[M.A.K. v.
Rush-Presbyterian-St.-Luke's Medical Center, 764 N.E.2d 1, 261 Ill.Dec. 710 (Ill.
2001)] The federal courts also recognized the psychiatrist- patient relationship and
protected those records from discovery in some legal proceedings. The federal courts
did not recognize the general physician patient relationship and, in some medical
business law cases, allowed the parties access to the records of patients being treated
by the hospital or physicians involved in the lawsuit. The Americans With
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