Confidentiality: Ethical Disclosure of Medical Information

Jessica Glaspell and Lee Dies

Dilemma 6: Medicine in the Service of the FBI

WANTED BY THE FBIA Federal Grand Jury in Tucson, Arizona indicted “Winifred Foxy Brown” for conspiring with another

individual in an act which involved the interstate transportation and unregistered possession of 120 sticks of dynamite, 30 electric blasting caps, 20 fuse caps, and 50 feet of fuse. Anthony Guiseppie using the name William Allen Friedman, allegedly drove from Venice, California to Tucson, Arizona, purchased the explosives and fuse and returned to Venice, California.

CAUTION: WINNIFRED FOXY BROWN HAS BEEN KNOWN TO ASSOCIATE WITH INDIVIDUALS WHO ADVOCATE THE USE OF EXPLOSIVES AND SHE HERSELF HAS ACQUIRED EXPLOSIVES. SHE REPORTEDLY MAY HAVE ACQUIRED FIRE-ARMS AND SHOULD BE CONSIDERED DANGEROUS.

Winifred Foxy Brown is known to be afflicted with a skin condition known as acne vulgaris, which has been described as acute and recurrent. The recurrent aspect of this skin condition could necessitate treatment by a health care practitioner, especially a dermatologist.

Winifred Foxy Brown is also known to frequently wear prescription eyeglasses or contact lenses, which are required for her to operate and automobile.

NOTIFY THE FBIAny person having information which may assist in location this fugitive is requested to immediately

notify the nearest FBI field office, the telephone number of which appears on the first page of most local telephone directories.

Breach of Confidentiality by the Physician

Justification for Breach of Confidentiality AMA Code of Medical Ethics:• Physician has an ethical duty to maintain

confidentiality between the physician and patient unless required by law• Exceptions are when a patient threatens bodily

harm to oneself or threaten to harm others

Breach of Confidentiality by the Physician Continued…

HIPPA Privacy Rule: Covered entities may disclose protected health information

to law enforcement for law enforcement purposes:1) To identify or locate a suspect, fugitive, material witness or

missing person.2) That they believe is necessary to prevent or lessen a serious

and imminent threat to a person or the public, when such disclosure is made to someone they believe can prevent or lessen the threat (including the target of the threat

3) Information needed to identify or apprehend an escapee or violent criminal

Is reporting of the person to the FBI related to the medical treatment and what action do you

support and why?The reporting of Winifred Foxy Brown is no way related to the medical treatment. • The physician is not disclosing medical information related to any treatment provided• Physician has a duty to the safety of the public to report Winifred to the FBI now that he has

gained knowledge of her being a fugitive and knowing her whereabouts. – This is seen in the non-consequentialism theory of ethics, or deontology. – According to Lucy Carter, “A deontologist simply judges the moral acceptability of an

action using a right-based or duty-based system of analysis. – Decisions are also made using duty-based justifications such as a duty to act on a certain

principle or a duty not to hinder some course of action.”• The physician is acting upon the principle of non-maleficence – the physician is taking

appropriate action to minimize harm to the public and the patient’s safety. • The principle of beneficence – By reporting her whereabouts, the physician is protecting

Winifred from the harm that could come to her by being a fugitive and being in possession of explosives.

• The principle of justice – All vulnerable groups are identified. The public safety is protected and Winifred pays for the crime she committed if convicted or is cleared if not.

Winifred Foxy Brown

Fugitive still has a right to privacy regarding her medical condition.

Winifred is not protected from the physician disclosing her whereabouts.

Even if fugitive is convicted on the said crime, she still has physician/patient privacy rights within the prison system concerning the acne vulgaris.

Works Cited

• American Medical Association. Patient Confidentiality. http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/patient-physician-relationship-topics/patient-confidentiality.shtml

• Carter, Lucy. OPPE, A Primer to Ethical Analysis. Office of Public Policy and Ethics, Institute for Molecular Bioscience, The University of Queensland, Australia. October 2002. http://ww.uq.edu.au/oppe.

• Microsoft Online Power Point Templates.• U.S. Department of Health and Human Services. Summary of the HIPAA Privacy Rule.

http://www.hhs.gov/ocr/privacy/hippa/understanding/summary/index.html