Reference no: EM131166269

ASSIGNMENT:

Examine this situation involving HIPAA and argue a stance on the ethical and legal implications involved for both the patient and hospital. Support statements with logic and argument.Does the current law need to be clarified or amended. Explain the reasons for your conclusion.

SITUATION:

Field Memorial is an acute care general hospital in Windsor County. It is owned and operated by a private, nonprofit corporation, and it has tax-exempt status under federal and state tax laws. Field Memorial provides a large volume of uncompensated care and service to Medicaid patients, but it receives no public funds from the county government. Windsor County has no public hospital. The only other hospital in the county is a for-profit facility that provides relatively little uncompensated care. Therefore, Field Memorial is the safety-net hospital for uninsured, underinsured, and Medicaid patients in the region. Under these circumstances, Field Memorial relies heavily on its insured patients to subsidize its indigent care and its losses on Medicaid patients. On April 6, 2013, George Long went to the outpatient department of Field Memorial for diagnosis and treatment of back pain. Long had made an appointment for that outpatient visit, and he arrived at Field Memorial on schedule. Long had been to Field Memorial many times for his back pain and for treatment of his mental health conditions. As indicated by his medical record at Field Memorial, Long had a history of mental health problems, including episodes of delusion. On that particular day, Long was escorted to an examining room in Field Memorial's outpatient department and was instructed to wait for the nurse.
A few minutes later, the nurse arrived to find Long running around the examining room in an agitated manner.

The nurse was unable to calm him and immediately called for the doctor. The doctor and nurse held Long's arms for about one minute until he became calm. After Long assured them that he could remain calm, the doctor completed examination of his back and instructed him to return in two weeks if he was still in pain. One week later, Long went to the office of a private, nonprofit advocacy organization called Patient Rights of Windsor County (PRWC) to discuss his recent experience at Field Memorial. Long told the president of PRWC that during his visit to Field Memorial on April 6, 2013, the doctor and nurse at Field Memorial had slapped him in the face and hit him in the stomach. With the help of the president of PRWC, Long called the local newspaper and gave this same account to a reporter. The reporter took detailed notes of the conversation with Long and then called the CEO of Field Memorial to hear her side of the story. However, the CEO replied that, because of privacy laws, she could not comment or provide any information about any individual patient at Field Memorial. The local newspaper published a story about Long's allegations, including the details of his statement and the fact that Field Memorial's CEO had no comment. Long has not filed a complaint with the police or with any government agency about this alleged incident, nor has he filed any legal action against Field Memorial or the individual healthcare professionals.

During the next few weeks, members of PRWC participated in a series of demonstrations on the public sidewalk in front of Field Memorial. Many of the PRWC members carried signs that stated "Stop Field Memorial from beating patients." The local newspaper published three stories about those demonstrations, in which the newspaper repeated Long's allegations and Field Memorial's refusal to comment. In the three months since the first newspaper report about Long's allegations, Field Memorial has experienced a severe drop in visits by patients who have coverage through commercial health insurance or employer-based health plans. It appears that a substantial majority of those insured patients have chosen to receive care at the for-profit hospital in the county or at hospitals in other counties. Field Memorial relies heavily on those insured patients to subsidize its indigent care and its losses on Medicaid patients. Field Memorial has determined that it will be unable to pay all of its operating expenses if this situation continues for another six months. The CEO of Field Memorial attempted to communicate with Long in an effort to resolve the matter or, at least, obtain his consent to allow Field Memorial to release his medical record to the local newspaper. The CEO even suggested that it might be possible to make a financial settlement with him, in exchange for a neutral press release that would be acceptable to both sides. However, Long refused to discuss any type of settlement and refused to consent to the release of his medical record. The board of trustees of Field Memorial ("the board") held an emergency meeting to discuss the situation and consider its options. After receiving an update from the management of Field Memorial, members of the board suggested various alternatives.

Board member A argued that Field Memorial must continue its current position of refusing to make any comment or provide any information about an individual patient. In contrast, board member B took the position that Long gave up his privacy by giving the mass media information-albeit false information-about his treatment at Field Memorial. Therefore, Long would have no right to complain if Field Memorial were to set the record straight by releasing his medical record, which would show that he has a long history of delusional episodes. Board member C stated that only a stupid law would prevent Field Memorial from defending itself and its staff under these circumstances, and disclosing a small amount of information about Long's medical history would be a technical violation at most. Finally, board member D argued that ethical considerations require disclosing Long's history of delusional episodes, because the potential harm to Long from his loss of privacy is vastly outweighed by the greater good of preserving the community's safety-net hospital, which is at serious risk of insolvency.