Tuesday, February 03, 2009


I'm finishing up preparations for a lecture on confidentiality and privacy for my Ethics in the ER course Wednesday, and came up with what I think is a great hook for discussion about a topic that is usually greeted as dry by many in the medical field. Here goes:

Who remembers their online HIPAA training course? If your experience is like mine, the topics of privacy and confidentiality seem like boring topics. This week on the blog, several of you posted very interesting accounts of dilemmas concerning confidentiality. If you didn't get a chance to read them yet, I'd encourage you to do so. So perhaps privacy isn't as dry as I first thought? Let's say you're not convinced by your classmates' challenges.

I'll step back a bit. Our medico-legal system may reinforce privacy as a topic learned by rote and repetition, but it gets a lot more interesting when you consider that this issue is at the core of the arguably most controversial Supreme Court ruling in the last half century. Can anyone guess what I'm talking about?

Roe v Wade was decided not based on statutes governing assault, or autonomy, or even Aquinas' principle of double effect. You couldn't guess that from the expressions, “right to choose” or "right to life."The case was decided on matters of privacy. Roe v Wade held that a woman's decision of an abortion falls well within privacy afforded by the 14th Amendment and the Bill of Rights. And since abortions these days are almost always in a medical setting, it's easy to see how the privacy from the state bleeds into the confidentiality afforded by patient-physician relationship.

If you are in the course and happened to find this post early, consider yourself a planted answer if no one responds to my question!

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