Challenging medical-legal norms. The role of autonomy, confidentiality, and privacy in protecting individual and familial group rights in genetic information.
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The Health Insurance Portability and Accountability Act (HIPAA) of 1996 addresses insurance reforms, medical savings accounts, fraud and abuse provisions, and health information standards. This report discusses HIPAA issues that could impact field triage and emergency medical services.
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One of the characteristics of a free society should be a strong presumption in favor of full patient control over personal information. The presumption is rebutted when disclosure to others is necessary (1) for good patient care, as in the case of consultations and medical teams; (2) to compile information that will produce scientific or medical progress; (3) to protect third parties from serious risks of harm; and (4) to prevent harm to patients themselves. In all of these cases, identifying information should be removed unless it is necessary. Principles of this sort should be implemented via physician norms, in fact publicly acknowledged physician norms, and (only) if necessary, by more formal regulations, private and public.
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