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Table of Contents
Think
Assess
Patient: Autonomy
Practitioner: Beneficence & Nonmaleficence
Public Policy: Justice
Conclude
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31. Medical Records
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The good medical practitioner treats the disease; the great medical practitioner treats the patient who has the disease.
~ William Osler
Privacy Breach
The Consequences of Violating HIPAA Law in Medical Records Access
Dr. Jane Smith was a well-respected physician at the local hospital. She had been practicing for over 20 years and had a reputation for providing excellent care to her patients. However, one day, the hospital’s IT department noticed some unusual activity in Dr. Smith’s electronic medical record (EMR) account. Upon further investigation, they discovered that Dr. Smith had been accessing the medical records of patients who were not under her care, and without their explicit consent.
The hospital’s compliance officer immediately launched an investigation into the matter. They found that Dr. Smith had been sharing patient information with her friend, who was not a healthcare provider, and that she had been doing so for several months. This was a clear violation of HIPAA law, and the hospital took swift action to hold Dr. Smith accountable.
Dr. Smith was brought before a panel of her peers, who were tasked with determining the appropriate disciplinary action for her actions. It was clear that Dr. Smith had violated the trust of her patients and the hospital. The panel concluded that Dr. Smith’s actions warranted the revocation of her medical license and the termination of her employment at the hospital.
The news of Dr. Smith’s actions and subsequent punishment shocked the local community. Patients who had trusted Dr. Smith with their care were left feeling violated and unsure if their personal medical information had been shared without their consent. The hospital worked tirelessly to rebuild the trust of their patients, and to ensure that all of their healthcare providers were properly trained on HIPAA laws and regulations.
The incident served as a stark reminder to healthcare providers of the importance of protecting their patients’ medical records. Medical records are the property of the patient, and healthcare providers have a responsibility to maintain confidentiality and privacy in accordance with HIPAA laws and regulations. The incident also highlighted the consequences that can arise from failing to uphold these standards, including the revocation of a medical license and the loss of employment.
In the end, the incident served as a valuable lesson to healthcare providers about the importance of treating the patient, not just the disease. Upholding the principles of autonomy, beneficence, nonmaleficence, and justice is essential to maintaining the trust of patients and the integrity of the medical profession.
Abstract
There are rights and responsibilities of both patients and medical practitioners regarding medical records. Patients have the legal right to access and copy the information in their medical records, which belong to them. Healthcare facilities cannot release medical records without the patient’s consent or a court order, as it is a violation of HIPAA law. The principle of autonomy is reflected in the informed consent of patients to disclose confidential information. Medical practitioners have a professional duty to maintain confidentiality and follow privacy protocols, guided by the professional principles of beneficence and nonmaleficence. There are exceptions such as therapeutic privilege, where withholding information is allowed to avoid harm to the patient. Society has laws in place to protect the confidentiality and privacy of medical records, based on the principle of justice. In certain circumstances, such as public safety or a court order, the practitioner may be mandated to disclose the medical record information.
**
[31:1] Medical records can be either physical or electronic, and although the medical records belong to the healthcare facility, the patient owns the content of the medical records. The patient has the legal right to access and copy all information that their medical records contain. Since the medical record’s information belongs to the patient, that information cannot be withheld from the patient for any reason, including nonpayment of bills. The patient does not have to provide any justification or reason for attaining access to the information in the medical records, as all that information is the property of the patient, even though the physical paper and electronic medical record is the property of the practitioner, clinic, or healthcare institution and which therefore always remains with the provider of care.
[31:2] Under no circumstances is the healthcare facility to release any of the patient’s medical records to anybody without either the patient’s explicit consent or because of a court order. To do otherwise is a violation of the Health Insurance Portability and Accountability Act (HIPAA) federal statute that may be punishable by fines of up to $250,000 and a jail term of up to 5 years.
[31:3] If there is any need for a correction in a physical medical record, then the medical-provider should draw a line through the error, initial the correction, and provide the current date and time. It is never permissible to whiteout mistakes, remove pages, or back-date any notes or corrections. Most healthcare institutions have moved from physical medical records to electronic medical records (EMRs), where there is much less opportunity or temptation to change or revise past entries. The same notation of author, date and time apply to emendations in an electronic medical record.
Assess
Patient: 1) Autonomy
[31:4] The bioethical principle of autonomy is not just manifested in the process of a patient providing informed consent for authorizing a treatment option; it is also manifested in the patient’s informed consent to disclose confidential and private information as found in the medical records. Although the interprofessional medical team must have readily available access to the patient’s medical records while treating the patient, all team members must follow strict confidentiality and privacy protocols.
[31:5] During clinical services, medical information must only be provided to the patient and the patient’s interprofessional medical-team, unless the patient has explicitly given the authority through consent that others, such as family members, should also receive the medical record information. Medical record information is the patient’s personal property, and violating confidentiality and privacy rules violates the patient-practitioner relationship in which protected health information (PHI) is to be kept confidential and private.
[31:6] One rare exception to this explicit requirement for the patient’s consent before disclosing the medical record’s information would be if there were to be a specific court order for that disclosure. Then the practitioner should only disclose the minimum amount of information requested and only to those given the authority to receive that information.
[31:7] Court order is an example of when the principle of justice (be fair) carries more moral weight than the principles of autonomy (informed consent), beneficence (do good), and nonmaleficence (do no harm) because it maximizes the best interests of the community at large.
Practitioner: 2) Beneficence & 3) Nonmaleficence
[31:8] Medical practitioners have a professional duty to disclose all medical records information to the patient and maintain strict confidentiality and privacy standards towards their patient’s protected health information (PHI). This patient-practitioner relationship mandate is based on the professional moral principles of beneficence (do good) and nonmaleficence (do no harm). Professional patient-centered medical-care occurs as the practitioner makes medical judgments based on what will maximize the patient’s best interests, as determined by the patient’s reasonable goals, values, and priorities as a matter of beneficence (do good).
[31:9] The patient’s best interests allow for circumstances in which, because of the therapeutic privilege, it is permissible not to disclose some information to the patient if disclosing the information would induce the patient to harm themselves or harm others—nonmaleficence (do no harm).
[31:10] Therapeutic privilege is an example of when the principle of nonmaleficence (do no harm) and the principle of justice (be fair) carry more moral weight than the principle of autonomy (informed consent) because it maximizes the best interests of the patient and the community at large.
[31:11] These exceptions are not instances of a violation of the patient-practitioner relationship. These exceptions are expected and understood as part of the social contract in which not recognizing these exceptions would violate the patient-practitioner relationship and social contract expectations.
Public Policy: 4) Justice
[31:12] Society has prohibited medical confidentiality and privacy violations based on the public policy principle of justice (be fair). Society and the legal system recognize the importance of the sanctity of the patient-practitioner relationship and therefore have legislated patient medical record information, confidentiality, and privacy laws. These laws promote the public’s trust and professional image of the medical profession.
[31:13] In general, only the patient and the patient’s interprofessional medical-care team have the legal right to access the patient’s medical record information. However, under extenuating circumstances, such as public safety and a court order, the practitioner is socially mandated to turn over a patient’s medical record information, even at the objection of the patient, but only by the practitioner delivering the minimal amount of requested information and then only to the appropriate authorities. This is not a violation of the patient-practitioner relationship; rather, it is an expected and understood part of the social contract in which doing anything otherwise would violate the patient-practitioner relationship.
Conclude
[31:14] Medical practitioners must recognize the patient confidentiality, privacy, access, and ownership of medical record information. Providing full patient access to all of the patient’s medical record information is a fundamental patient right established by society and the medical profession.
[31:15] In summary, the sanctity of medical records is essential to the patient-practitioner relationship and the trust the public has in the medical profession. Medical practitioners must recognize and respect the rights of patients concerning their medical records, including confidentiality, privacy, access, and ownership. By upholding these principles, practitioners can help maintain a strong patient-practitioner relationship and preserve the integrity of the medical profession.
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31. Review Questions
1. The institution owns both the physical or electronic medical records and the content in those records.
2. It is permissible to deny the patient a copy of their medical record due to unpaid medical bills.
3. It is unnecessary to get explicit authority from the patient to share the patient’s medical information with the patient’s family and loved ones.
4. The principle of autonomy (informed consent) always has more moral weight than the principles of beneficence (do good), nonmaleficence (do no harm), and justice (be fair).
5. Therapeutic privilege where information is not disclosed to the patient and court order where information is given to others without consent are not breaches of the patient-practitioner relationship.
**
CORRECT! 🙂
[31:1] Medical records can be either physical or electronic, and although the medical records belong to the healthcare facility, the patient owns the content of those medical records. The patient has the legal right to access and copy all information that their medical records contain. Since the medical record’s information belongs to the patient, that information cannot be withheld from the patient for any reason, including nonpayment of bills. The patient does not have to provide any justification or reason for attaining access to the information in the medical records as all that information is the property of the patient even though the physical paper and electronic medical record is the property of the practitioner, clinic, or healthcare institution and which therefore always remains with the provider of care.
Wrong 😕
[31:1] Medical records can be either physical or electronic, and although the medical records belong to the healthcare facility, the patient owns the content of those medical records. The patient has the legal right to access and copy all information that their medical records contain. Since the medical record’s information belongs to the patient, that information cannot be withheld from the patient for any reason, including nonpayment of bills. The patient does not have to provide any justification or reason for attaining access to the information in the medical records as all that information is the property of the patient even though the physical paper and electronic medical record is the property of the practitioner, clinic, or healthcare institution and which therefore always remains with the provider of care.
CORRECT! 🙂
[31:1] Medical records can be either physical or electronic, and although the medical records belong to the healthcare facility, the patient owns the content of those medical records. The patient has the legal right to access and copy all information that their medical records contain. Since the medical record’s information belongs to the patient, that information cannot be withheld from the patient for any reason, including nonpayment of bills. The patient does not have to provide any justification or reason for attaining access to the information in the medical records as all that information is the property of the patient even though the physical paper and electronic medical record is the property of the practitioner, clinic, or healthcare institution and which therefore always remains with the provider of care.
Wrong 😕
[31:1] Medical records can be either physical or electronic, and although the medical records belong to the healthcare facility, the patient owns the content of those medical records. The patient has the legal right to access and copy all information that their medical records contain. Since the medical record’s information belongs to the patient, that information cannot be withheld from the patient for any reason, including nonpayment of bills. The patient does not have to provide any justification or reason for attaining access to the information in the medical records as all that information is the property of the patient even though the physical paper and electronic medical record is the property of the practitioner, clinic, or healthcare institution and which therefore always remains with the provider of care.
CORRECT! 🙂
[31:5] During clinical services, medical information must only be provided to the patient and the patient’s interprofessional medical-team, unless the patient has explicitly given the authority through consent that others, such as family members, should also receive the medical record information. Medical record information is the patient’s personal property, and violating confidentiality and privacy rules violates the patient-practitioner relationship in which protected health information (PHI) is to be kept confidential and private.
Wrong 😕
[31:5] During clinical services, medical information must only be provided to the patient and the patient’s interprofessional medical-team, unless the patient has explicitly given the authority through consent that others, such as family members, should also receive the medical record information. Medical record information is the patient’s personal property, and violating confidentiality and privacy rules violates the patient-practitioner relationship in which protected health information (PHI) is to be kept confidential and private.
CORRECT! 🙂
[31:8] Practitioners have a professional duty to disclose all medical records information to the patient and maintain strict confidentiality and privacy standards towards their patient’s protected health information (PHI). This patient-practitioner relationship mandate is based on the professional moral principles of beneficence (do good) and nonmaleficence (do no harm). Professional patient-centered medical-care is where the practitioner makes medical judgments based on what will maximize the patient’s best interests, as determined by the patient’s reasonable goals, values, and priorities as a matter of beneficence (do good).
[31:10] Therapeutic privilege is an example of when the principle of nonmaleficence (do no harm) and the principle of justice (be fair) carry more moral weight than the principle of autonomy (informed consent) because it maximizes the best interests of the patient and the community at large.
[31:13] In general, only the patient and the patient’s interprofessional medical-care team have the legal right to access the patient’s medical record information. However, under extenuating circumstances, such as public safety and a court order, the practitioner is socially mandated to turn over a patient’s medical record information, even at the objection of the patient, but only by the practitioner delivering the minimal amount of requested information and then only to the appropriate authorities. This is not a violation of the patient-practitioner relationship; rather, it is an expected and understood part of the social contract in which doing anything otherwise would violate the patient-practitioner relationship.
Wrong 😕
[31:8] Practitioners have a professional duty to disclose all medical records information to the patient and maintain strict confidentiality and privacy standards towards their patient’s protected health information (PHI). This patient-practitioner relationship mandate is based on the professional moral principles of beneficence (do good) and nonmaleficence (do no harm). Professional patient-centered medical-care is where the practitioner makes medical judgments based on what will maximize the patient’s best interests, as determined by the patient’s reasonable goals, values, and priorities as a matter of beneficence (do good).
[31:10] Therapeutic privilege is an example of when the principle of nonmaleficence (do no harm) and the principle of justice (be fair) carry more moral weight than the principle of autonomy (informed consent) because it maximizes the best interests of the patient and the community at large.
[31:13] In general, only the patient and the patient’s interprofessional medical-care team have the legal right to access the patient’s medical record information. However, under extenuating circumstances, such as public safety and a court order, the practitioner is socially mandated to turn over a patient’s medical record information, even at the objection of the patient, but only by the practitioner delivering the minimal amount of requested information and then only to the appropriate authorities. This is not a violation of the patient-practitioner relationship; rather, it is an expected and understood part of the social contract in which doing anything otherwise would violate the patient-practitioner relationship.
Wrong 😕
[31:10] Therapeutic privilege is an example of when the principle of nonmaleficence (do no harm) and the principle of justice (be fair) carry more moral weight than the principle of autonomy (informed consent) because it maximizes the best interests of the patient and the community at large.
[31:13] In general, only the patient and the patient’s interprofessional medical-care team have the legal right to access the patient’s medical record information. However, under extenuating circumstances, such as public safety and a court order, the practitioner is socially mandated to turn over a patient’s medical record information, even at the objection of the patient, but only by the practitioner delivering the minimal amount of requested information and then only to the appropriate authorities. This is not a violation of the patient-practitioner relationship; rather, it is an expected and understood part of the social contract in which doing anything otherwise would violate the patient-practitioner relationship.
CORRECT! 🙂
[31:10] Therapeutic privilege is an example of when the principle of nonmaleficence (do no harm) and the principle of justice (be fair) carry more moral weight than the principle of autonomy (informed consent) because it maximizes the best interests of the patient and the community at large.
[31:13] In general, only the patient and the patient’s interprofessional medical-care team have the legal right to access the patient’s medical record information. However, under extenuating circumstances, such as public safety and a court order, the practitioner is socially mandated to turn over a patient’s medical record information, even at the objection of the patient, but only by the practitioner delivering the minimal amount of requested information and then only to the appropriate authorities. This is not a violation of the patient-practitioner relationship; rather, it is an expected and understood part of the social contract in which doing anything otherwise would violate the patient-practitioner relationship.
31. Clinical Vignettes
1. Mr. Gage Nicholson, a 40-year-old software developer, requests a copy of his medical records from his practitioner. His medical records include information about his allergies and past surgeries. Who owns the physical or electronic medical records and the content in those records?
2. Mr. Hayden Garcia is a 55-year-old accountant who has been diagnosed with hypertension and Type 2 diabetes. He requests that his practitioner change his medical record to reflect that his hypertension and diabetes were pre-existing conditions before he started visiting this healthcare facility. What is the appropriate response of the practitioner?
3. Ms. Violet Sullivan is a 50-year-old teacher who has been seeing a doctor for the past year to manage her high blood pressure. After missing several appointments, she receives a bill for unpaid medical bills, including charges for the missed appointments. Ms. Sullivan contacts her doctor’s office to request a copy of her medical records but is told that the office cannot provide her with a copy due to her unpaid medical bills. Is it permissible to deny Ms. Sullivan a copy of her medical records due to unpaid medical bills?
4. Mr. Alex Cooper, a 68-year-old retired maintenance director was admitted to the hospital with chest pain. After several tests and a consultation with a cardiologist, Mr. Cooper is diagnosed with a heart attack and requires further treatment. During his hospital stay, Mr. Cooper's family members, who are not directly involved in his care, call the hospital and ask about his condition. The hospital staff informs them that Mr. Cooper is admitted and receiving treatment but cannot provide any specific medical information due to patient confidentiality laws. However, Mr. Cooper has expressed to the practitioner that he does not want his family members to know about his medical condition. What should the practitioner do in this situation?
5. Mr. Steven Williams is a 42-year-old construction worker who comes to the clinic with symptoms of chest pain, shortness of breath, and fatigue. After taking a detailed history and performing a physical examination, the differential diagnosis includes a possible myocardial infarction, pneumonia, or pulmonary embolism. As the practitioner, you explain to Mr. Williams the importance of conducting diagnostic tests and procedures to rule out potential health problems, and you recommend hospitalization for further workup. What ethical obligation do you have as a medical practitioner regarding Mr. Williams' medical records?
CORRECT! 🙂
Explanation: The healthcare facility owns both the physical or electronic medical records and has the right to access the content of those records based on need for medical care [31:1]. However, the patient owns the right to access and the content of those records, and to obtain a copy of the information contained in those records under HIPAA law [31:1]. The patient cannot make changes to the information in those records, which is the legal property of the healthcare facility [31:1]. The other options are incorrect the patient does not own the physical or electronic medical records, rather the institution does, and the patient, and the institution cannot delete or make changes to the information in those records.
Wrong 😕
Explanation: The healthcare facility owns both the physical or electronic medical records and has the right to access the content of those records based on need for medical care [31:1]. However, the patient owns the right to access and the content of those records, and to obtain a copy of the information contained in those records under HIPAA law [31:1]. The patient cannot make changes to the information in those records, which is the legal property of the healthcare facility [31:1]. The other options are incorrect the patient does not own the physical or electronic medical records, rather the institution does, and the patient, and the institution cannot delete or make changes to the information in those records.
Wrong 😕
Explanation: Patients have the legal right to access and copy their medical records, even without providing a reason [31:2]. Therefore, it is not permissible to deny Ms. Sullivan a copy of her medical records due to her unpaid medical bills [31:4]. Furthermore, refusing to provide a copy of medical records due to nonpayment of medical bills violates the principle of patient autonomy, which mandates the informed consent of patients to disclose confidential information, including medical record information [31:4]. Additionally, withholding medical record information due to unpaid medical bills would be in direct violation of the Health Insurance Portability and Accountability Act (HIPAA) federal statute [31:2]. All other options are incorrect because it is not permissible to deny patient access to their medical records.
CORRECT! 🙂
Explanation: Under the HIPAA privacy rule, a patient has the right to request an added amendment to their medical record if the information is incorrect or inaccurate [31:1]. However, the practitioner is not allowed to make any changes even if incorrect [31:1]. In this case, the practitioner should explain to the patient that the information in the medical record cannot be changed. Changing the medical record at the patient's request would be a violation of the law and medical ethics, as medical records are legal documents and must be accurate and complete [31:1]. The other options are incorrect because changing the medical record to reflect the patient's request or violating the law and medical ethics would not be appropriate responses.
CORRECT! 🙂
Explanation: Patients have the legal right to access and copy their medical records, even without providing a reason [31:2]. Therefore, it is not permissible to deny Ms. Sullivan a copy of her medical records due to her unpaid medical bills [31:4]. Furthermore, refusing to provide a copy of medical records due to nonpayment of medical bills violates the principle of patient autonomy, which mandates the informed consent of patients to disclose confidential information, including medical record information [31:4]. Additionally, withholding medical record information due to unpaid medical bills would be in direct violation of the Health Insurance Portability and Accountability Act (HIPAA) federal statute [31:2]. All other options are incorrect because it is not permissible to deny patient access to their medical records.
Wrong 😕
Explanation: The practitioner was not negligent in ordering a CT scan based on their clinical judgment, which was supported by Ms. Davis's symptoms [29:2]. Medical standards of care are based on the hypothetical practices of a reasonably competent practitioner in the same or similar community that address the same medical condition of the malpractice claim [29:2]. In this case, the practitioner met the medical standard of care by ordering a CT scan to confirm their clinical suspicion of pneumonia, despite the radiologist's report [29:2]. The practitioner's clinical judgment was supported by Ms. Davis's symptoms, which warranted further investigation to ensure an accurate diagnosis and prompt treatment [29:2]. The practitioner was not negligent in ordering a CT scan based on their clinical judgment, as it complied with medical standards of care [29:2]. The radiologist was negligent in misreading the chest X-ray, but cannot be held liable because there was no resultant harm to the patient as there was no significant delay in the diagnosis [29:2].
Wrong 😕
Explanation: In this situation, the practitioner should respect Mr. Cooper's right to medical privacy and confidentiality, as outlined in HIPAA laws [31:2]. The ethical principle of autonomy requires that medical information must only be provided to the patient and the patient's interprofessional medical-team, unless the patient has explicitly given the authority through consent that others, such as family members, should also receive the medical record information [31:5]. Therefore, the practitioner should inform Mr. Cooper of his family members' concerns and allow him to decide whether to share his medical information with them. This approach not only upholds Mr. Cooper's right to privacy and autonomy but also ensures that his family members' concerns are addressed. It is important to note that while the hospital staff cannot provide specific medical information without explicit consent, they can acknowledge that the patient is receiving treatment and is admitted to the hospital [31:2].
CORRECT! 🙂
Explanation: In this situation, the practitioner should respect Mr. Cooper's right to medical privacy and confidentiality, as outlined in HIPAA laws [31:2]. The ethical principle of autonomy requires that medical information must only be provided to the patient and the patient's interprofessional medical-team, unless the patient has explicitly given the authority through consent that others, such as family members, should also receive the medical record information [31:5]. Therefore, the practitioner should inform Mr. Cooper of his family members' concerns and allow him to decide whether to share his medical information with them. This approach not only upholds Mr. Cooper's right to privacy and autonomy but also ensures that his family members' concerns are addressed. It is important to note that while the hospital staff cannot provide specific medical information without explicit consent, they can acknowledge that the patient is receiving treatment and is admitted to the hospital [31:2].
CORRECT! 🙂
Explanation: Mr. Williams has the legal right to access and copy his medical records, which belong to him, as per the HIPAA law. The medical practitioner has an ethical and legal obligation to maintain confidentiality and follow privacy protocols, and the patient's right to access and copy their medical records is a fundamental patient right established by society and the medical profession [31:1-3]. The patient's medical record information is the patient's personal property, and violating confidentiality and privacy rules violates the patient-practitioner relationship in which protected health information (PHI) is to be kept confidential and private [31:4-5]. The medical practitioner can only disclose the minimal amount of requested information and only to those given the authority to receive that information if there is a specific court order for that disclosure [31:6]. It is not permissible to withhold the medical record information from the patient for any reason, including nonpayment of bills. The other options are incorrect because denying patient access to the medical records is a violation of the patient's legal right to access, a court order is not required for patient access, and it is not true that the practitioner’s consent is required for a patient to access their medical records.
Wrong 😕
Explanation: Mr. Williams has the legal right to access and copy his medical records, which belong to him, as per the HIPAA law. The medical practitioner has an ethical and legal obligation to maintain confidentiality and follow privacy protocols, and the patient's right to access and copy their medical records is a fundamental patient right established by society and the medical profession [31:1-3]. The patient's medical record information is the patient's personal property, and violating confidentiality and privacy rules violates the patient-practitioner relationship in which protected health information (PHI) is to be kept confidential and private [31:4-5]. The medical practitioner can only disclose the minimal amount of requested information and only to those given the authority to receive that information if there is a specific court order for that disclosure [31:6]. It is not permissible to withhold the medical record information from the patient for any reason, including nonpayment of bills. The other options are incorrect because denying patient access to the medical records is a violation of the patient's legal right to access, a court order is not required for patient access, and it is not true that the practitioner’s consent is required for a patient to access their medical records.
**
31. Reflection Vignette
1. Ms. Jane Smith, a 45-year-old accountant, presents to the medical office requesting a copy of her medical records. Upon reviewing her account, the practitioner notices that Ms. Smith has an outstanding balance of several thousand dollars for previous medical services rendered. The practitioner informs Ms. Smith that the practice has a policy of not releasing any medical records until the patient's outstanding balance has been resolved. The practitioner advises Ms. Smith that she can set up a payment plan to pay off the balance and receive her medical records once the plan has been agreed upon. It's worth noting that the practitioner's policy of withholding medical records until the patient has paid their bills is both unethical and illegal. The patient has the right to access their own medical records, and the practitioner's refusal to provide them until a payment plan has been agreed upon is a clear violation of the patient's rights. Healthcare providers have a legal and ethical obligation to provide patients with access to their medical records, regardless of their financial situation.
Think
Assess
Patient: Autonomy
Practitioner: Beneficence & Nonmaleficence
Public Policy: Justice
Conclude
**
2. Mr. John Doe, a 42-year-old businessman, comes into the clinic and demands that all physical and electronic medical records related to him are destroyed and erased. However, the practitioner informs him that there are certain legal and practical limitations to his request. While the patient may own the information in his medical records, the physical and electronic media that contain that information are usually owned by other institutions and practices. Furthermore, destroying the records could cause harm to the patient if they were to require medical treatment in the future and important medical history is missing. The practitioner explains that the patient may request for certain information to be withheld or redacted from the records, but complete destruction of all records is not possible.Think
Assess
Patient: Autonomy
Practitioner: Beneficence & Nonmaleficence
Public Policy: Justice
Conclude
***
