March 13, 2013
HIPAA, The Moral and Ethical Dilemmas
“Privacy and confidentiality have been foundational principles of medical ethics since the time of Hippocrates” (Rothstein & Talbott, 2007, p. 38). Several years ago the US Congress passed the Health Insurance Portability and Accountability Act (HIPAA) to protect the privacy and confidentiality of medical records and personal information. These efforts mostly focus on preventing unauthorized use or disclosure of a persons health information (Rothstein & Talbott, 2007). These laws need to be in place to protect this information from entities that will do harm or unjustifiably use this information to harm an individual. However, this leaves us to consider the impact on public health that has been created when a healthcare worker is unable to share knowledge of ones health information that may cause harm or threat to others. In this essay I will discuss the intended and consequential impact of the implementation of HIPAA on both the individual and society as a whole. I will discuss the four classical virtues of justice, courage, prudence, and temperance. Additionally, I will discuss the three fundamental important values of the healthcare professions in relation to HIPAA and public safety. I will also discuss the ethical system of consequentialism and how it is applied to the public health model of our era. “The HIPAA Privacy Rule establishes national standards to protect individuals’ medical and other personal health information and applies to health plans, healthcare clearinghouses, and those healthcare providers that conduct certain healthcare transactions electronically. The Role requires appropriate safeguards to protect the privacy of personal health information, and set limits and conditions on the uses and disclosures that may be made of such information without patient authorization”. (Wartenberg & Thompson, 2010, p. 407) This role was in response to valid concerns regarding the privacy of medical records and other personal health information. From its conception HIPAA has become one of the most significant healthcare governing laws of our generation. It is the first thing addressed with each patient interaction throughout the country’s healthcare system. I do believe in the sanctity of HIPAA, although the true question that we must evaluate is the balance of an individual’s privacy protection and the protection of the public. The penalties for violations of HIPAA are severe. These penalties include not only significant monetary damage, but also the threat of criminal prosecution. “A person who knowingly obtains or discloses individually identifiable health information in violation of HIPAA could face a fine of $50,000 and imprisonment for up to one year” (www.omh.ny.gov). In the event that the violation is a result of malfeasance these penalties increase dramatically. As healthcare workers the threat of these penalties certainly impacts our ability to balance HIPAA clearly due to the threat of our livelihood. First and foremost in nursing, when dealing with patients, we apply the virtues of beneficence and non-malfeasance to our decision making processes. We want to always “do good” for our patients and “do no harm”. There are times when we are taking care of our patients and they divulge information to us that could possibly result in a threat or harm to others. At times, HIPAA binds our hands on what we can do to protect the others in order to keep our patients health information private. Legally, we are not allowed to divulge our patient’s information, but morally and ethically as a registered nurse I struggle with this. As registered nurses we want to do right by our patients, but then realize we also have to think of the greater good of the public. Privacy is held to be an individual fundamental right. According to...