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8/8/2019 Docs Patriot Act
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BMJ Publishing Group
Doctors Outraged At Patriot Act's Potential To Seize Medical RecordsAuthor(s): Jeanne LenzerSource: BMJ: British Medical Journal, Vol. 332, No. 7533 (Jan. 14, 2006), p. 69Published by: BMJ Publishing GroupStable URL: http://www.jstor.org/stable/25455841
Accessed: 10/10/2010 05:40
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8/8/2019 Docs Patriot Act
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News
Doctorsoutraged
at Patriot Act's
potential to seize medical records
Jeanne Lenzer New York
US doctors across thepolitical
spectrumare
protestingat a
pro
vision in the Patriot Act that
allows the government to seize
patients' medical records without
aprobable
cause or a warrant.
The actprohibits doctors from
telling anyone, includingthe
patient,that their sensitive medi
cal records have been seized.
Doctors who violate thegagging
order can be fined and prosecut
ed for obstruction ofjustice.
The Association of American
Physicians and Surgeons (a lib
ertarian group based in Tucson,
Arizona) and the American Civil
Liberties Union, which has many
doctor members, havejoined
in
a coalition, called Patriots to
Restore Checks and Balances, to
urge Congressto amend Section
215 of the act. Theprovision,
whichonly recen?y
came to
light,allows the Federal Bureau
ofInvestigation (FBI) to
geta
secret court order to seize"any
tangible things," includingmedi
cal records, student or work
records, and evenlibrary
records. Coalition members say
that medical records areunlikely
toprovide useful information
about terrorists.
The act, passedin the wake of
the 11 September 2001 terrorist
attacks, gives the governmenta
broad range ofrights
to monitor
US citizens and is set toexpire
on
3February. President Bush is urg
ing Congressto renew the act He
said, "We're still under threat,
there's still anenemy that wants to
harm us, andthey
understand the
Patriot Act is animportant tool
for those of us here in the execu
tive branch to use toprotect
our
fellow citizens."
The inclusion of medical
records washighlighted by
a
reporter, Joy Buchanan from the
DailyPress in
Newport News, Vir
ginia, who was alerted to a clause
in one medical centres' brochure
for patients on privacy.
The brochure stated that the
centre"may
disclose medical
information about you to auth
orised federal officiais sothey
may without limitation (i)provide
protectionto the President, other
authorised personsor
foreignheads of state or conduct
special
investigations,or (ii) conduct law
fulintelligence, counter-intelli
gence,or other national
security
activities authorisedby
law."
Ms Buchananreported
the
story in theDaily
Press on 29
December (sect A: 1).
Subsequent investigations
have shown thatvirtually
all
medical centres haveincorporat
ed the same or similarlanguage
in their brochures. Under the
Health InsurancePortability and
Accounting Act, patientsmust
be told that their records arepri
vate and about any exceptionsto
that rule. The statements are
Housejudiciary chairman, James Sensenbrenner (centre), at a news
conference on the Patriot Act with homeland security committee
chairman PeterKing (left) and the
attorney general,Alberto Gonzales
often asingle paragraph
in
documents several pages long,which are
givento
patients
beforethey
see a doctor.
Michael Williams, associate
professor ofneurology
and neu
rosurgery atJohns Hopkins Uni
versity, Baltimore, said most
peoplein the United States don't
seem to know about Section 215.
"Ionly
found out about it in
June 2005 at ameeting
of the
American Medical Association.
Ifpatients
knew about this, I
thinkthey
would be bothered?
or Ihope they would be," he
said. "If our records can be
seized with nosafeguards then
we're all in trouble."
DuaneCady, chairman of the
board of the American Medical
Association, said that the associa
tionadopted
a newpolicy
inJune
2005"calling
for modifications to
the Patriot Act toprotect patient
confidentialityand minimise
legal
liabilityfor
physicians."
Congressman DanLungren
of California defended the pro
visionallowing
the seizure of
medical records. He said itmight
beimportant
to know if, for
example,someone connected to
an international terroristorgani
sation soughtan anthrax vac
cine. He said the government
couldn't afford to be limitedby
the need for"probable
cause."
There is an "essential differ
ence," he said, "between a crimi
nalinvestigation
toprove who
committed a crime after it's
occurred and the need to pre
vent terrorist attacks."
Jane Orient, executive direc
tor of the Association of Ameri
canPhysicians
andSurgeons,
warned, "This waragainst
terror
ism is atotally open ended affair,
and the definition of terrorism is
[overly] broad." D
Seewww.aclu.org/privacy/
medical/ 15222res20030530.html.
UK drug companies must disclose
funding of patients' groupsMichael
DayLondon
Drug companiesmust make
publictheir involvement with
patients' advocacy groups, under
a revisedindustry
code of prac
tice introduced in the United
Kingdom this month.
From 1January firms are
expectedto name all
patients'
organisations that receive their
financialsupport. They
must
also set out details of such rela
tionshipsand any funding pro
vided, say the new rules of the
Association of the British Phar
maceuticalIndustry. The
update
of the code wasprompted partly
bythe severe criticism the indus
try received in theparliamentary
health select committee's reporton the influence of
drug compa
nies, publishedin
Aprillast year.
Aspokesman
for the associa
tion said: "This isdesigned
to
ensure that the industry's
involvement withpatient groups
iscompletely transparent. It's
now up to thevoluntary
sector
to do theirpart."
Charles Medawar, who runs
thecampaign group Social
Audit, said, "Links with patient
groupsare now considered such
amajor marketing
tool and such
anintegral way of
competing
with thecompetition,
I doubt the
industrywill
voluntarilyalter
thingstoo much."
However, Harry Cayton, the
government's national director
for patients and thepublic, wel
comed the revised code of prac
tice?and he also called on
patients' organisationsto show a
similar level oftransparency.
He said, "I welcome this
move?and I would urge
patients' groups to beequally
as
upfront.The charitable sector
does need to raise itsgame."
MrCayton
said thatduring
his time as chief executive of the
Alzheimer'sSociety
the group
received a small amount of itsincome ("less than 0.1 per cent")
from thedrug industry but that
itwas declared.
Simon Williams, director of
policyat the Patients Associa
tion, said: "Some groups simply
couldn't survive without money
from thepharmaceutical indus
try, buttransparency is
vitally
important and notonly
in terms
ofdrug company funding.
If a
group gets money from another
source, say the government, that
should be declared too. We
make it clear on our publications
and annualreports of any fund
ingwe receive." D
Key changesto the code are listed
atwww.abpi.org.uk/press/
press_releases_05/051116b.asp.
BMJ VOLUME 332 14JANUARY 2006 bmj.com 69