RT 205: Module 5 TRUTHFULNESS AND CONFIDENTIALITY

Truthfulness

defined as conformance with fact or reality.

Veracity

the obligation to the truth and not to lie or deceive others.

lie

is a falsehood told to another who has a reasonable expectation of the truth.

The expectation of truth varies with the following conditions:

- The Place of Communication
- Role of communication
- The nature of the truth involved

The Place of Communication

is the environment of the expectation of truth

Role of communication

the relationship between the communicators, which may have an impact on the expectation of truth

The nature of the truth

can alter the expectation of truth in matters of privacy.

Right to the truth

A person has the right to truthful communication during the informed consent process when making treatment decisions and when making important nonmedical decisions.

Confidentiality

is the duty owed by healthcare providers to protect the privacy of patient information

secret

is a knowledge a person has the right or obligation to conceal.

Obligatory secrets

are secrets that arise from the fact that harm will follow if a particular knowledge is revealed.”

Obligatory secrets

- Natural Secrets
- Promised Secrets
- Professional Secrets

Natural Secrets

Information shared by its nature harmful and is revealed

Promised Secrets

- Knowledge a person has promised to conceal.

- The harmful effects of breaking a promise complicate professional relationships and discourage the sharing of privileged information that may be vital to patient care

Professional Secrets

- The most binding of the obligatory secrets

- When professional secrets are revealed, both the patient and the imaging profession are harmed

Exceptions to confidentiality

Some exceptions to confidentiality are mandated by state law.

- Wounds
- Abuse
- Communicable diseases
- Accidents
- Birth defects
- Addictions
- Family's need to know
- Public's need to know
- Third-party payers

(HIPAA) Health Insurance Portability and Accountability Act

clarifies to some extent what may or may not be disclosed. These include situations when patient authorization is required; statutory duties to disclose; the duty to warn third parties of danger; and AIDS and HIV confidentiality and reporting.

Patient Authorization

Patients may explicitly consent to the release of medical information in their records.

Statutory Disclosure

HIPAA allows medical professionals and institutions to report certain medical conditions and incidents to state public health authorities.

RA No. 7610

Special Protection of Children Against Abuse, Exploitation and Discrimination Act

SECTION 3. Reporting

A person who learns of facts or circumstances that give rise to the belief that a child has suffered abuse may report the same, either orally or in writing, to the Department, to the police or other law enforcement agency or to a Barangay Council for the Protection of Children

SECTION 4. Mandatory Reporting

The head of any public or private hospital, medical clinic and similar institution, as well as the attending physician and nurse, shall report, either orally or in writing, to the Department the examination and/or treatment of a child who appears to have suffered abuse within forty-eight (48) hours from knowledge of the same.

RA No. 11332 or Section 6

Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act

Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act

All public and private physicians, allied medical personnel, professional societies, hospitals, clinics, health facilities, laboratories, institutions, workplaces, schools, prisons, ports, airports, establishments, communities, other government agencies, and NGOs are required to accurately and immediately report notifiable diseases and health events of public health concern as issued by the DOH

Duty to warn third parties

The duty to maintain confidentiality may come into conflict with the duty to disclose information to third parties to warn them of a risk such as violence or contagious disease.

RA No. 11166

Philippine HIV and AIDS Policy Act

Acquired Immune Deficiency Syndrome (AIDS)

refers to a health condition where these is a deficiency of immune system that stems from infection with the Human Immunodeficiency Virus or HIV, making an individual susceptible to opportunistic infections

Human Immunodeficiency Virus (HIV)

refers to the virus, of the type called retrovirus, which infects cells of the human immune system, and destroys or impairs the cells' function. Infection with HIV results in the progressive deterioration of the immune system. Leading to immune deficiency.

Section 44. Confidentiality.

The confidentiality and privacy of any individual who has been tested for HIV, has been exposed to HIV, has HIV infection or HIV- and AIDS-related illnesses, or was treated for HIV-related illnesses shall be guaranteed.

TORTS REGARDING CONFIDENTIALITY

- Breach of Confidentiality
- Patient Access to Medical Records
- Defamation

Breach of Confidentiality

This duty stems largely from the right to privacy, but courts have imposed liability based on statutes defining expected conduct, ethical duties owed to the patient, breach of the fiduciary duty to maintain confidentiality, and breach of contract or implied contract between patient and physician or health care facility

Patient Access to Medical Records

An area of concern in patient confidentiality is patients' access to medical records

Defamation

is the utterance or publication of an unprivileged false statement that hurts another's reputation. If the publication is oral, the defamation is slander; if written, it is libel.

tort of defamation

is based on the right to maintain a good reputation.

Truth

is a total defense to a charge of defamation.

Libel/slander per se

no specific injury must be proven for certain types of defamation, including statements about criminal activity, diseases, business misdeeds, or unchastity