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McHale asks why a doctor can be forced to disclose a patients' confidences in court when other professional confidences are protected. She goes on to look at whether doctors keep patients' confidences and the need for statutory reform.
Regional health care databases are being established around the country with the goal of providing timely and useful information to policymakers, physicians, and patients. But their emergence is raising important and sometimes controversial questions about the collection, quality, and appropriate use of health care data. Based on experience with databases now in operation and in development, Health Data in the Information Age provides a clear set of guidelines and principles for exploiting the potential benefits of aggregated health dataâ€"without jeopardizing confidentiality. A panel of experts identifies characteristics of emerging health database organizations (HDOs). The committee explores how HDOs can maintain the quality of their data, what policies and practices they should adopt, how they can prepare for linkages with computer-based patient records, and how diverse groups from researchers to health care administrators might use aggregated data. Health Data in the Information Age offers frank analysis and guidelines that will be invaluable to anyone interested in the operation of health care databases.
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.
The need for quality improvement and for cost saving are driving both individual choices and health system dynamics. The health services research that we need to support informed choices depends on access to data, but at the same time, individual privacy and patient-health care provider confidentiality must be protected.
Medical confidentiality is universally recognised as a value worth protecting. However, difficulties arise when confidential medical information becomes relevant in the context of crime prevention and criminal prosecution. Should medical confidentiality be upheld where the physician holds information which is essential for the investigation of a serious crime; for establishing the truth in a criminal trial; for an accused’s defence; or for the prevention of a criminal offence? And according to which criteria should such decisions be made? Based on an examination of different approaches in medical ethics and a comparison of the relevant law of France, Germany, England and Wales and the US, this book analyses how a balance of the competing interests can best be struck.
This book, for the first time, offers a comparative study of the origins of professional and public debates on medical confidentiality in the US, Britain, and Germany during the late nineteenth and early twentieth centuries. In this period traditional medical secrecy began to be seriously contested by demands for disclosure in the name of public health and the law. Andreas-Holger Maehle examines three representative debates: Do physicians and surgeons have a privilege to refuse to give evidence in court about confidential patient details? Can doctors breach patient confidence in order to prevent the spread of disease? And is there a medical duty to report illegal procedures to the authorities? The comparative approach reveals significant differences and similarities among the three countries concerned, and the book s historical perspective illuminates the fundamental ethical issues at stake that continue to give rise to public debate."
