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Confidentiality in Medicine

Edited by Ruchika Mishra (Program in Medicine and Human Values, California Pacific Medical Center)
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  1. R. Accordino, N. Kopple-Perry, N. Gligorov & S. Krieger (2014). The Medical Record as Legal Document: When Can the Patient Dictate the Content? An Ethics Case From the Department of Neurology. Clinical Ethics 9 (1):53-56.
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  2. Anita L. Allen (2011). Commercial Speech Bruises Health Privacy in the Supreme Court. Hastings Center Report 41 (6):8-9.
    Heath services come with the promise of confidentiality.1 The ethical mandate to safeguard the confidentiality of personal health information aligns with legal mandates to do the same. Numerous state and federal laws demand one form of health data confidentiality or another, best illustrated by the Health Insurance Portability and Accountability Act.2 In early 2011, the Department of Health and Human Services decided to take a tougher stand against HIPAA violators, utilizing powers created by the Health Information Technology for Economic and (...)
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  3. George J. Annas, Daryl Matthews & Leonard H. Glantz (1980). Patient Access to Medical Records. Journal of Law, Medicine and Ethics 8 (2):17-18.
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  4. Robert Baker (2006). Confidentiality in Professional Medical Ethics. American Journal of Bioethics 6 (2):39 – 41.
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  5. John Balint (2006). Should Confidentiality in Medicine Be Absolute? American Journal of Bioethics 6 (2):19 – 20.
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  6. Jennifer S. Bard (2011). When Public Health and Genetic Privacy Collide: Positive and Normative Theories Explaining How ACA's Expansion of Corporate Wellness Programs Conflicts with GINA's Privacy Rules. Journal of Law, Medicine and Ethics 39 (3):469-487.
    The Patient Protection and Affordable Care Act of 2010 (ACA) contains many provisions intended to increase access to and lower the cost of health care by adopting public health measures. One of these promotes the use of at-work wellness programs by both providing employers with grants to develop these programs and also increasing their ability to tie the price employees pay for health insurance for participating in these programs and meeting specific health goals. Yet despite ACA's specific alteration of three (...)
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  7. Samuel Bard (1769/1996). A Discourse Upon the Duties of a Physician: With Some Sentiments, on the Usefulness and Necessity of a Public Hospital: Delivered Before the President and Governors of King' College, Held on the 16th of May 1769: As Advice to Those Gentlemen Who Then Received the First Medical Degrees Conferred by That University. [REVIEW] Applewood Books.
    This classic essay on the responsibilities of a doctor was first published in New York in 1769. It remains a perfect gift for a young doctor just starting out or for one who is older and wiser. This classic will be an inspiration to any who read its timeless message.
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  8. Tom L. Beauchamp (2009). Principles of Biomedical Ethics. Oxford University Press.
    This edition represents a thorough-going revision of what has become a classic text in biomedical ethics. Major structural changes mark the revision. The authors have added a new concluding chapter on methods that, along with its companion chapter on moral theory, emphasizes convergence across theories, coherence in moral justification, and the common morality. They have simplified the opening chapter on moral norms which introduces the framework of prima facie moral principles and ways to specify and balance them. Together with the (...)
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  9. Tom L. Beauchamp (1994). Principles of Biomedical Ethics / Tom L. Beauchamp, James F. Childress. Oxford University Press.
    This is an extremely thorough revision of the leading textbook of bioethics. The authors have made many improvements in style, organization, argument and content. These changes reflect advances in the bioethics literature over the past five years. The most dramatic expansions of the text are in the comprehensiveness with which the authors treat different currents in ethical theory and the greater breadth and depth of their discussion of public policy and public health issues. In every chapter, readers will find new (...)
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  10. David B. Brushwood (1984). Is There a Pharmacist-Patient Privilege? Journal of Law, Medicine and Ethics 12 (2):63-67.
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  11. Thomas E. Cargill (1984). The Importance of Patient Privacy. Journal of Law, Medicine and Ethics 12 (1):2-2.
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  12. Elliot D. Cohen (2003). Lethal Sex. International Journal of Applied Philosophy 17 (2):253-265.
    Confidentiality in psychological counseling is necessary if clients are to feel comfortable in revealing their darkest secrets. But this bond of trust has its moral limits. These limits are crossed in some cases in which HIV positive clients are sexually active with unsuspecting third parties. Distinguishing between Type 1 and Type 2 cases, the author shows how he has used applied ethics in drafting and defending a model rule for the American Counseling Association’s Code of Ethics that permits, and sometimes (...)
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  13. Ann Freeman Cook & Helena Hoas (2013). The Truth About the Truth: What Matters When Privacy and Anonymity Can No Longer Be Promised to Those Who Participate in Clinical Trial Research? Research Ethics 9 (3):97-108.
    The ramifications of including genetic components in the clinical studies conducted in non-academic settings create unique ethical challenges. We used a qualitative research design consisting of semi-structured interviews that took place between October 2010 and September 2012. The sample consisted of 80 participants − 38 physicians and 42 coordinators − who worked across a number of different settings, including clinics, private practices, small hospitals, free standing research centers, and blended hospital-institutes in both rural and urban communities in 13 states across (...)
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  14. M. A. Crook (2013). The Risks of Absolute Medical Confidentiality. Science and Engineering Ethics 19 (1):107-122.
    Some ethicists argue that patient confidentiality is absolute and thus should never be broken. I examine these arguments that when critically scrutinised, become porous. I will explore the concept of patient confidentiality and argue that although, this is a very important medical and bioethical issue, this needs to be wisely delivered to reduce third party harm or even detriment to the patient. The argument for absolute confidentiality is particularly weak when it comes to genetic information and inherited disease.
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  15. Christian Lenk, Nils Hoppe, Katharian Beier & Claudia Wiesemann (eds.) (2011). Human Tissue Research. A European Perspective on the Ethical and Legal Challenges. Oxford University Press.
    It will be of value to medics and social scientists, human tissue researchers, and policy makers who have an interest in ethical and legal issues of human tissue research.
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  16. Ruth Macklin (1991). HIV-Infected Psychiatric Patients: Beyond Confidentiality. Ethics and Behavior 1 (1):3 – 20.
    The AIDS epidemic calls for an ethical analysis of conflicting obligations surrounding HIV-infected psychiatric patients and confidentiality, as well as issues that go beyond confidentiality. Although laws pertaining to HIV infection have been enacted in a number of states, these statutes leave much discretion to health professionals. The ethical principle known as "the harm principle" can permit disclosure of confidential information and detention or isolation of psychiatric patients who pose a threat of infecting other patients. From an ethical point of (...)
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  17. Bardia Monshi & Verena Zieglmayer (2004). Articles: The Problem of Privacy in Transcultural Research: Reflections on an Ethnographic Study in Sri Lanka. Ethics and Behavior 14 (4):305 – 312.
    Western laws and codes of ethics frequently require that private health information be treated confidentially. However, cross-cultural research shows that it is not always easy to determine what members of a culture consider to be private or how they wish private information to be handled. This article begins by presenting an ethnographic study of patient-healer relationships in Sri Lanka; researchers were surprised to find that participants' views of health and privacy differed greatly from typical Western views, and that the privacy (...)
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  18. Abraham P. Schwab, Lily Frank & Nada Gligorov (2011). Saying Privacy, Meaning Confidentiality. American Journal of Bioethics 11 (11):44-45.
    The American Journal of Bioethics, Volume 11, Issue 11, Page 44-45, November 2011.
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  19. David Shaw (2013). Communicating About Communicable Diseases on Facebook: Whisper, Don't Shout. Public Health Ethics (1):pht031.
    Mandeville and colleagues describe a fascinating case where Facebook was used to warn potential contacts that their acquaintance had a communicable disease (Mandeville et al., 2013). They are correct that this case raises important issues about social media, confidentiality and the prevention of harm. However, they underestimate both the dangers of overcommunication via Wall and Timeline postings (and Twitter) and the potential utility of Facebook in cases like this one. Increased awareness of Facebook functionality will allow more accurate targeting of (...)
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  20. David Shaw (2010). Transatlantic Issues: Report From Scotland. Cambridge Quarterly of Healthcare Ethics 19 (3):310-320.
    Several bioethical topics received a great deal of news coverage here in Scotland in 2009. Three important issues with transatlantic connections are the swine flu outbreak, which was handled very differently in Scotland, England and America; the US debate over healthcare reform, which drew the British NHS into the controversy; and the release to Libya of the Lockerbie bomber, which at first glance might not seem particularly bioethical, but which actually hinged on the very public discussion of the prisoner’s medical (...)
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  21. David Shaw (2008). Dentistry and the Ethics of Infection. Journal of Medical Ethics 34 (3):184-187.
    Currently, any dentist in the UK who is HIV-seropositive must stop treating patients. This is despite the fact that hepatitis B-infected dentists with a low viral load can continue to practise, and the fact that HIV is 100 times less infectious than hepatitis B. Dentists are obliged to treat HIV-positive patients, but are obliged not to treat any patients if they themselves are HIV-positive. Furthermore, prospective dental students are now screened for hepatitis B and C and HIV, and are not (...)
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  22. Lauren Slive & Ryan Cramer (2012). Health Reform and the Preservation of Confidential Health Care for Young Adults. Journal of Law, Medicine and Ethics 40 (2):383-390.
    A major issue facing the health of young adults in the United States is the often unintentional lack of confidentiality maintained in the provision of sensitive health services. Of primary concern is that young adults who remain on their parents' health insurance plans forgo Sexually Transmitted Infection screening and treatment, as well as other sensitive services such as family planning services and mental health treatment out of a concern that explanation of benefit forms from such services will inform their parents, (...)
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  23. James L. Werth, Caroline Burke & Rebekah J. Bardash (2002). Confidentiality in End-of-Life and After-Death Situations. Ethics and Behavior 12 (3):205 – 222.
    Confidentiality is one of the foundations on which psychotherapy is built. Limitations on confidentiality in the therapeutic process have been explained and explored by many authors and organizations. However, controversy and confusion continue to exist with regard to the limitations on confidentiality in situations where clients are considering their options at the end of life and after a client has died. This article reviews these 2 areas and provides some suggestions for future research.
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