Confidentiality of medical records. An overview of concepts and legal policies

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Abstract

Conceptual confusion about privacy and confidentiality is widespread in court opinions, statutes, regulations, current literature, and policies of health care institutions. Although it is difficult to clarify the concept of privacy, the concept of confidentiality is more amenable to precise characterization. In the first section of this article the concepts of privacy and confidentiality will be analyzed and, more importantly, clearly distinguished from each other. This clarification is crucial to a coherent discussion of the primary concern: confidentiality of medical records. In the second section of the article the confidentiality of medical records will be examined in the context of health care services. The nature of medical records as well as the value of confidentiality to patients and health care professionals will be discussed. The management of medical records will be viewed in terms of ownership, control, access, and disclosures to third parties. It will then be argued that the value of confidentiality of medical records is sometimes in conflict with and subordinate to the needs for public safety, truth, and knowledge. The third section of the article provides an overview of federal and state regulation of the confidentiality of medical records. The aim of this section is to depict trends rather than to offer a comprehensive and detailed survey of current law. This will be followed by an identification of some key problem areas where inevitable future controversies will generate a need for further legal regulation and institutional policy making. Some suggestions are made about preferable legal and policy directions for the future.

Original languageEnglish (US)
Pages (from-to)497-533
Number of pages37
JournalJournal of Legal Medicine
Volume3
Issue number4
StatePublished - 1982
Externally publishedYes

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ASJC Scopus subject areas

  • Social Sciences (miscellaneous)
  • Law

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