More on Privacy Laws and Violence

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Locked up too tight?

Today’s Washington Post offers yet another article on the effect of (often) well-meaning privacy laws when they are applied to potentially violent persons who are not following treatment guidelines or showing premonitory signs of becoming psychotic along with a chance of potential violence.

Wide-ranging privacy laws came into effect under the Health Insurance Privacy and Policy Act (HIPPA in 2003. The main aim was a good one—confidentiality is paramount in all interactions that go on between patients and doctors. A patient must give signed consent in order for any treatment records to be released.

The so-called law of unintended consequences has created many unfortunate applications of this universal law. Now when patients go to a doctor’s office or hospital, they are called to the window by as loud voice: “Is Suzy here?” The patient, who is a grandmother of eight and a respected scientist, then goes to the window. There is not longer the respect shown by using “Ms.” or “Mr.” because this would release a last name.

There are exceptions where information can be released but these usually involve IMMINENT danger such as regarding suicide and violence. The criteria for reporting child abuse or terrorism are not as strict.
Clinicians may hesitate to report a patient who is potentially but not imminently violent: this can be grounds for a serious law suit by the patient claiming that the reporter has exaggerated or not understood the symptoms, leading to inappropriate releases of information.

There are interactions between HIPPA and state laws which can cause complications. For example, some states set the lega

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