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What is truthfulness?
conformity with fact or reality (a fluid concept)
What is veracity?
obligation to tell the truth and not to lie or deceive others
Veracity is fundamental to the establishment of ___
trust among individuals
Truthfulness is summed up in 2 commands:
do not lie (this rule alone allows tech to say nothing at all to avoid lying)
communicate with those (and only those) who have a right to the truth
What is a lie?
a falsehood told to another who has a reasonable expectation of truth
Lies are judged in terms of ___
consequences for the individual and society
Expectations of the truth vary with what 3 conditions?
place of communication
role of communication
nature of the truth involved
(all 3 are related to obligation of confidentiality and right to privacy)
Explain place of communication as a condition of expectations of the truth
the environment of the expectation of truth
should be in a private setting
do not want anyone overhearing and possibly becoming distressed
Where can the student have an expectation of truth 100% of the time?
in the confidential classroom setting
Explain role of communication as a condition of expectations of the truth
relationship between the communicators
role of imaging caregiver and patient (or any two parties)
Explain nature of the truth involved as a condition of expectations of the truth
alters the expectation of truth in questions concerning private matters
caregiver should not expect a truthful answer (if asking anything of a personal or private nature)
there is no reasonable expectation of the truth
Is concealment of the truth considered a lie?
not necessarily
Informed consent process is necessary when ___
making decisions about treatment and when making important nonmedical decisions
Explain the roles of the radiologist and technologist in discussing exam results with patients
radiologist or physician can provide detailed information on exam results
imaging professionals do not have the authority to discuss pathologic findings with patients
What is confidentiality?
duty owed by health care providers to protect the privacy of patient information
Confidentiality concerns the keeping of ___
secrets
What is a secret?
knowledge a person has a right or obligation to conceal
What are obligatory secrets?
secrets that arise from the fact that harm will follow if a particular knowledge is revealed
What are the 3 types of obligatory secrets?
natural secret
promised secret
professional secret
Explain natural secrets (as 1 of the 3 types of obligatory secrets)
information shared in a natural secret is by nature harmful if revealed
ex: HIV status
Explain promised secrets (as 1 of the 3 types of obligatory secrets)
a secret that the receiver has promised to conceal
harmful effects of breaking a promise
breach of confidentiality AND lose trust as employees or friends
Explain professional secrets (as 1 of the 3 types of obligatory secrets)
the most binding of the obligatory secrets
both the patient and the imaging professional are harmed
damage to the reputation of the professional, their department, and their institution
The ___ was published by the ___, and discusses professional secrets
The Patient’s Bill of Rights; American Hospital Association
The Patient’s Bill of Rights discusses ___
the importance of professional secrecy has been recognized by society and a body of laws have been created that encourages privileged communication
What are some exceptions to confidentiality that are mandated by state laws?
certain types of wounds (i.e. gunshots)
communicable diseases
auto accidents
abuse (imaging professionals are required to report suspected cases of child or elder abuse)
birth defects
industrial accidents
drug addiction (only in some states)
What does HIPAA stand for?
Health Insurance Portability and Accountability Act of 1996
What are the 3 major purposes of HIPAA?
to protect and enhance the rights of consumers by providing them access to their health information and controlling the inappropriate use of that information
to improve the quality of health care in the U.S. by restoring trust in the health care system among consumers, health care professionals, and the multiple organizations and individuals committed to the delivery of care
to improve the efficiency and effectiveness of health care delivery by creating a national framework for health privacy protection that builds on efforts by states, health systems, and the individual organizations and individuals
When information is required to be released, can you release all information?
NO; only the minimum necessary information for the purpose of disclosure should be released, rather than the entire record
With HIPAA, when are disclosures allowed without permission from the patient?
disclosing to the patient
to other health care providers for treatment purposes
for payment of services
for health care services (ie. quality assurance info)
appointment reminders
treatment alternatives
health-related benefits
approved research projects
What are some HIPAA special circumstances?
subpoenas or court-ordered disclosures required by law
law enforcement requests
to other entities for billing purposes
organ and tissue donors
public health risks
What are some patient rights that are created or reinforced by HIPAA?
the right to…
inspect and copy their records
ask for the information to be amended if the patient believes it to be inaccurate
ask what disclosures have been made
request restriction of the information disclosure
request the method of communication
a paper copy of the privacy notice of the institution
If info disclosure permission is given, does that permission last forever?
no; it may be revoked in writing at any time
Release of patient information to outside reviewers is governed by ___
state law and HIPAA
Explain the relationship between HIPAA and state law
HIPAA supersedes state law in most respects and covers VA hospitals and other federal facilities
Does state law override HIPAA regulations?
NO
The Medicare program requires providers to ___
allow peer review organizations access to records of Medicare patients
What should imaging professionals do in regards to patient authorization?
consult the risk management department, in the absence of statutory or judicial support for the release of information to outside reviewers
The sharing of information from the patient medical record poses ___ risks
liability
___ are the most common outside requesters of medical information
third party payers
Is patient consent necessary for release of information to third party payers?
used to be, but is not necessary anymore
Most insurers require patients to authorize ___ when they file for payment
the release of information
Statutory disclosure says that the duty to report is a legal obligation to include:
venereal disease
contagious disease (such as TB)
wounds inflicted by violence
poisonings
industrial accidents
abortions
drug abuse
abuse of children, elderly people, and people with disabilities
Why are some things required to report (statutory disclosure)?
to protect public health
The duty to warn third parties is the obligation to ___
disclose information of a risk of violence or contagious disease (or some other risk)
Warning to third parties is usually based on ___
statutes
Warning third parties may come in conflict with ___
the duty of confidentiality
Breach of confidentiality extends to ___
oral, written, and computer communication as well as reproduction of records and employee conduct
Breach of duty to hold information in confidence may cause ___
liability for the individual and the facility
What is breach of confidentiality?
breach of contract or implied contract between the patient and the health care provider or health care facility
What is defamation?
the making of a false statement to a third party that is harmful to another’s reputation (said to another person about a patient, family member, visitor, employee, or a physician)
Defamation can be ___ or ___
written or spoken
What is slander?
defamation statement expressed orally
What is libel?
defamation statement that is written
In order for something to be considered defamation, ___
harm MUST have resulted from the false statement
What is slander per se or libel per se?
statement concerns criminal activity, a loathsome disease, business/trade/professional misdeeds
no specific injury needs to be proved