To maintain the bond between patients and their care givers, it is essential for confidentiality to be upheld. The article on patient perspectives researches the patient beliefs about accessing medical records and poses the following questions: 1) “whether patients approve of their physicians sharing medical information with other physicians”; 2) “under what circumstances patients might sanction breaches of confidentiality”; and 3) “patient opinions about sharing medical information with employers, families, and third parties” (Sankar, et al, 2003). Each of the questions allows a focus on topics that make confidentiality so important.
The first question presents the basic principle of confidentiality, who should medical records be shared with? The reason that coordinated care is so important is because better outcomes are achievable. It is the healthcare workers responsibility to relay this coordination to the patient in a way that helps them to understand how it will benefit their care. The patient perspective article also concludes that patients agree that access to medical records should be restricted to those involved directly in care delivery (Sankar, 2003).
As part of the HIPAA privacy rule, the patient can designate a personal representative who, outside of caregivers, has access to their medical records (HHS, n.d). According to Sankar et al, patient opinions on when a breach of confidentiality would be acceptable are not agreed upon by all, but depend on the severity of the problem or situation. Abuse, neglect, or suicidal tendency could be an arguable reason to break confidentiality, or to relieve someone of the burden of disclosure. All do feel that there are only certain conditions that warrant such a betrayal of the confidentiality agreement between patient and physician.
Breach in Confidentiality
Access of records to third parties is often perceived as a breach in confidentiality and can be detrimental to the relationship and participation of the patient. Many patients, according to Sankar et al., will choose not to divulge a complete medical history or other pertinent information if they feel like their confidentiality is not being upheld. The Reamer (2001) article defines some of the ethical reasons for breaching confidentiality and explains how the responsibility for protection sometimes supersedes. Patient safety and