(Part 2 of an ongoing series)
As a healthcare ethics speaker, healthcare ethics consultant and book author, I am hardly surprised that when present and former patients have been asked, “What are some examples of ethical issues in healthcare?” that the issue currently represents about 20 percent of their top concerns.
Despite HIPAA, the Health Insurance Portability and Accountability Act, patients are still quite concerned about breaches of their confidentiality.
On a personal basis, a close friend of mine related a story from just a few years ago you might he interested in noting. My friend was having problems with his hearing and being a responsible person had an evaluation with a recommended otolaryngologist.
He left the physician’s office, had a quick lunch, and on his way back to the office, stopped at his home to check the mail. Stuffed into his mailbox were several brochures from a local audiologist and hearing aid center. Clearly, someone in the physician’s office was feeding patient information – undoubtedly for the purpose of kickbacks.
Maryville University recently presented an online article on the topic of patient confidentiality and they stated:
“Patient confidentiality supports the needs of both patient and physician. It protects patients from having their data misused. It also serves the physicians’ best interests. For example, doctor-patient confidentiality privileges — which assure patients that their health information is safe and only will be used for the purposes of improving health outcomes — allow doctors to establish relationships with patients based on trust and open communication, thus improving the quality of care they provide.”
Lingering problems
Despite the awareness of the seriousness with which patients take the issue of confidentiality, problems persist. As a healthcare ethics speaker and healthcare ethics consultant, these issues repeatedly come up whenever I speak to groups on healthcare ethics. Confidentiality is violated in a number of unexpected as well as “expected ways.”
In a recently published (September 26, 2022) article on Patient Confidentiality, authors A. Tariq Rayhan and Pamela B. Hackert remind us of all those in a healthcare setting who must adhere to HIPAA.
The extensive list the authors provide includes: Healthcare providers, nurses, pharmacists, administrative personnel, foodservice, clerical workers, janitorial services, external laboratories, external imaging services, outside computer repair, accredited agencies that conduct patient surveys, medical equipment companies and pharmaceutical salespeople.
Leaks can – and do – happen that can breach confidentiality. Obviously, it need not be physicians, PA’s or nurses, but anyone with access to files or who are inadvertently sharing information. Because healthcare settings are frequently accessed by sales reps, suppliers and repair personnel, it takes effort as well as strict policy to maintain boundaries.
While patients might be told that confidentiality is strictly maintained, on a “private basis,” I have been told by meeting or seminar attendees that patient information is not always held as sacred as we are led to believe.
Unless ethics training is put into place with frequent reinforcement due to turnover, patient information can potentially be shared and abused.
The Web Portal
According to a recent survey taken by the American Academy of Family Physicians, about 70 percent of their offices use web portal technology. Web portal technology has proven a boon to healthcare. However, breaches do occur, and with it, a loss of patient confidentiality.
In an article on confidentiality by Joel Witt, April 1, 2022, it was noted:
“A survey of one hundred hospital IT executives revealed that small and mid-sized hospitals are most at risk of cyber-attack, with 48% of executives revealing that their organization had been forced to shut down in the last six months due to a cyber-attack.”
Most breaches occur not because of Ransomware by foreign actors but due to employees opening unauthorized email attachments or social media usage at work or allowing unauthorized individuals access to the platform.
As a healthcare ethics speaker, healthcare ethics consultant and book author, I implore organizations to properly train everyone operating within the system on ethical behavior.
To answer, “What are some examples of ethical issues in healthcare?” Small practices and major facilities alike need not look for mysterious reasons for data leaks of confidential information but usually, unethical behavior much, much closer to home.
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