Medical Records and the Law

Statutory Provisions Regarding Disclosure 353directly to other healthcare providers for purpose of treating the patient.32 In addition, the laws reflect a concern for the safety of medicalworkers who are at risk for HIV infection during performance of theirduties. Several statutes authorize the attending physician to reveal anHIV patient’s identity to other healthcare workers who come into contactwith body fluids or body parts of the patient, or who work directlywith HIV patients. 33Some statutes permit disclosure upon finding that the healthcareworker has a “reasonable” or “medical” need to know the information inorder to provide proper care. Other laws allow disclosure whenevergenerally relevant to the patient’s treatment. Many of the laws are unclear,however, as to whether the authorized disclosures are permissiveor mandatory. This question bears on the ability of a concerned workerto demand that a physician confirm the test results of a patient who theworker suspects is positive for the virus. Many statutes also are unclearas to whose interests must be analyzed for purposes of such disclosure—theworker’s or the patient’s. For example, a “need to know” forpurposes of providing patient care may refer to the worker’s need totake precautions to prevent becoming infected while rendering treatmentto the patient; on the other hand, the “need to know” might relateto special treatments available only for AIDS patients.Not every healthcare worker involved with the patient has a legitimateneed to know that the person has been tested for HIV; only a limitedclass of medical practitioners have access to such informationunder HIV confidentiality statutes. In California, for example, the resultsof an HIV test may be recorded in the subject’s record and otherwiserevealed without the patient’s consent to providers of care forpurposes of “diagnosis, care, or treatment of the patient.” 34 Accordingly,the results of an HIV test may be disclosed to a healthcareprovider’s agent or employee who provides “direct patient care andtreatment.” 35 Similarly, Maine authorizes disclosure of HIV test resultsto the healthcare provider designated by the patient, and the patient’s32See, e.g., Cal. Health & Safety Code § 120985(a); Haw. Rev. Stat. § 325-101(a)(10);Iowa Code § 141.23(1)(d); Me. Rev. Stat. Ann. tit. 5, § 19203(2); Mich. Comp. Laws §333.5131(5)(a)(iii); W.Va. Code § 16-3c-3(a)(5).33See, e.g., Cal. Health & Safety Code §§ 120985(a) and 121010(b) through (e); Kan. Stat.Ann. § 65-6004(a); 410 Ill. Comp. Stat. Ann. § 305/9(h).34Cal. Health & Safety Code § 120985(a).35Cal. Health & Safety Code § 121010(c).