Patient views about consent, confidentiality and information-sharing in genetic medicine
Sandi Dheensa, Angela Fenwick, and Anneke Lucassen
J Med Ethics doi:10.1136/medethics-2015-102781
Abstract
In genetic medicine, a patient's diagnosis can mean their family members are also at risk, raising a question about how consent and confidentiality should function in clinical genetics. This question is particularly pressing when it is unclear whether a patient has shared information. Conventionally, healthcare professionals view confidentiality at an individual level and ‘disclosure without consent’ as the exception, not the rule. The relational joint account model, by contrast, conceptualises genetic information as confidential at the familial level and encourages professionals to take disclosure as the default position. In this study, we interviewed 33 patients about consent and confidentiality and analysed data thematically. Our first theme showed that although participants thought of certain aspects of genetic conditions—for example, the way they affect day-to-day health—as somewhat personal, they perceived genetic information—for example, the mutation in isolation—as familial. Most thought these elements were separable and thought family members had a right to know the latter, identifying a broad range of harms that would justify disclosure. Our second theme illustrated that participants nonetheless had some concerns about what, if any, implications there would be of professionals treating such information as familial and they emphasised the importance of being informed about the way their information would be shared. Based on these results, we recommend that professionals take disclosure as the default position, but make clear that they will treat genetic information as familial during initial consultations and address any concerns therein.
The article is here.
Showing posts with label Confidentiality. Show all posts
Showing posts with label Confidentiality. Show all posts
Thursday, February 11, 2016
Monday, January 18, 2016
Under Gun Rules, FBI Will Receive Health Data
By Robert Pear
The New York Times
Originally posted January 6, 2016
Here is an excerpt:
Virtually every push for new gun sale restrictions in recent years has been greeted by opponents countering with proposals to address mental health as a factor in gun violence.
“For those in Congress who so often rush to blame mental illness for mass shootings as a way of avoiding action on guns, here’s your chance to support these efforts,” Mr. Obama said at the White House on Tuesday.
But that challenge moved the administration into a thicket of difficult health questions. Under a rule published Wednesday in the Federal Register, the background check system run by the Federal Bureau of Investigation will receive the names of people who are forbidden to buy or own firearms because they have been involuntarily committed to a mental institution or found to pose a danger to themselves or others.
The article is here.
The New York Times
Originally posted January 6, 2016
Here is an excerpt:
Virtually every push for new gun sale restrictions in recent years has been greeted by opponents countering with proposals to address mental health as a factor in gun violence.
“For those in Congress who so often rush to blame mental illness for mass shootings as a way of avoiding action on guns, here’s your chance to support these efforts,” Mr. Obama said at the White House on Tuesday.
But that challenge moved the administration into a thicket of difficult health questions. Under a rule published Wednesday in the Federal Register, the background check system run by the Federal Bureau of Investigation will receive the names of people who are forbidden to buy or own firearms because they have been involuntarily committed to a mental institution or found to pose a danger to themselves or others.
The article is here.
Wednesday, January 13, 2016
Your health records are supposed to be private. They aren’t.
By Charles Ornstein
The Washington Post
December 30, 2015
Here is an excerpt:
In each story, a common theme emerged: HIPAA wasn’t working the way we expect. And the agency charged with enforcing it, the HHS office for civil rights, wasn’t taking aggressive action against those who violated the law.
We all know HIPAA, whether we recognize the acronym or not. It’s what requires us to stand behind a line, away from other customers, at the pharmacy counter or when checking in at the doctor’s office. It is the reason we get privacy declaration forms to sign whenever we visit a new medical provider. It is used to scare health-care workers, telling them that if they improperly disclose others’ information, they could pay a steep fine or even go to jail.
But in reality, it is a toothless tiger. Unless you’re famous, most hospitals and clinics don’t keep tabs on who looks at your records if you don’t complain. And even though the civil rights office can impose large fines, it rarely does: It received nearly 18,000 complaints in 2014 but took only six formal actions that year. A recent report from the HHS inspector general said the office wasn’t keeping track of repeat offenders, much less doing anything about them.
The story is here.
The Washington Post
December 30, 2015
Here is an excerpt:
In each story, a common theme emerged: HIPAA wasn’t working the way we expect. And the agency charged with enforcing it, the HHS office for civil rights, wasn’t taking aggressive action against those who violated the law.
We all know HIPAA, whether we recognize the acronym or not. It’s what requires us to stand behind a line, away from other customers, at the pharmacy counter or when checking in at the doctor’s office. It is the reason we get privacy declaration forms to sign whenever we visit a new medical provider. It is used to scare health-care workers, telling them that if they improperly disclose others’ information, they could pay a steep fine or even go to jail.
But in reality, it is a toothless tiger. Unless you’re famous, most hospitals and clinics don’t keep tabs on who looks at your records if you don’t complain. And even though the civil rights office can impose large fines, it rarely does: It received nearly 18,000 complaints in 2014 but took only six formal actions that year. A recent report from the HHS inspector general said the office wasn’t keeping track of repeat offenders, much less doing anything about them.
The story is here.
Wednesday, January 6, 2016
New Jersey Psychology Practice Revealed Patients’ Mental Disorders in Debt Lawsuits
By Charles Ornstein
ProPublica, Dec. 23, 2015
When a New Jersey lawyer named Philip received legal papers last year informing him that his former psychologist’s practice was suing him over an unpaid bill, he was initially upset they could not work out a payment arrangement outside of court.
It was only later, Philip said in an interview, that he scanned the papers again and realized something else: The psychology group to which he’d confided his innermost feelings had included his mental health diagnosis and treatments he received in publicly filed court documents.
The greatest fear of many patients receiving therapy services is that somehow the details of their private struggles will be revealed publicly. Philip, who requested his last name not be used to protect his privacy, said he felt “betrayed” by his psychologist. He worried that his legal adversaries would find the information and try to use it against him in court.
“It turned my life upside down,” he said.
The article is here.
ProPublica, Dec. 23, 2015
When a New Jersey lawyer named Philip received legal papers last year informing him that his former psychologist’s practice was suing him over an unpaid bill, he was initially upset they could not work out a payment arrangement outside of court.
It was only later, Philip said in an interview, that he scanned the papers again and realized something else: The psychology group to which he’d confided his innermost feelings had included his mental health diagnosis and treatments he received in publicly filed court documents.
The greatest fear of many patients receiving therapy services is that somehow the details of their private struggles will be revealed publicly. Philip, who requested his last name not be used to protect his privacy, said he felt “betrayed” by his psychologist. He worried that his legal adversaries would find the information and try to use it against him in court.
“It turned my life upside down,” he said.
The article is here.
Monday, November 9, 2015
When Students Become Patients, Privacy Suffers
By Charles Ornstein
ProPublica
Originally published October 23, 2015
Here is an excerpt:
Yale Health’s website informs parents that they cannot access their child’s health information without a signed written consent form. Andrea said she does not recall signing that document. When she recently asked to see any such form, she said, she was told by the counseling center’s chief that there was none. “Most of what happened while I was in the hospital happened without my knowing it,” she said. “I got an update every day or two about where my life was going.”
Andrea’s case is a vivid demonstration of how weaknesses in state and federal laws — and the often-conflicting motives of students, parents, and college officials — have left patient privacy vulnerable when students receive medical treatment on campus.
Universities walk a fine line when providing that treatment or mental-health services to students. If campus officials don’t know what’s going on or disclose too little, they risk being blamed if a student harms himself, herself, or others. If they pry too deeply, they may be accused of invading privacy, thereby discouraging students from seeking treatment.
The entire article is here.
ProPublica
Originally published October 23, 2015
Here is an excerpt:
Yale Health’s website informs parents that they cannot access their child’s health information without a signed written consent form. Andrea said she does not recall signing that document. When she recently asked to see any such form, she said, she was told by the counseling center’s chief that there was none. “Most of what happened while I was in the hospital happened without my knowing it,” she said. “I got an update every day or two about where my life was going.”
Andrea’s case is a vivid demonstration of how weaknesses in state and federal laws — and the often-conflicting motives of students, parents, and college officials — have left patient privacy vulnerable when students receive medical treatment on campus.
Universities walk a fine line when providing that treatment or mental-health services to students. If campus officials don’t know what’s going on or disclose too little, they risk being blamed if a student harms himself, herself, or others. If they pry too deeply, they may be accused of invading privacy, thereby discouraging students from seeking treatment.
The entire article is here.
Thursday, November 5, 2015
A Code of Ethics for Health Care Ethics Consultants
Anita J. Tarzian & Lucia D. Wocial
American Journal of Bioethics 15 (5):38-51 (2015)
Abstract
For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here.
The entire paper is here.
American Journal of Bioethics 15 (5):38-51 (2015)
Abstract
For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here.
The entire paper is here.
Sunday, October 25, 2015
Doctors' use of smartphones 'could threaten patient confidentiality'
By Denis Campbell
The Guardian
Originally published October 7, 2015
Details of patients’ illnesses and treatment could be leaked because so many doctors use smartphones to send details of their cases to each other, including x-ray results and photographs of wounds, warns research.
Patients are at risk of having their confidentiality breached because up to two-thirds of doctors are using SMS texts and picture messages to share information, including photographs of wounds, in the search for a second opinion.
The findings prompted concern that sensitive details of patients’ conditions could become public if doctors’ phones were lost or stolen or they inadvertently sent a message to a wrong number.
Research among 287 doctors and 564 nurses working at the five hospitals in the Imperial College healthcare NHS trust in London found that 65% of the doctors had used SMS messages to communicate with colleagues about a patient.
The entire article is here.
The Guardian
Originally published October 7, 2015
Details of patients’ illnesses and treatment could be leaked because so many doctors use smartphones to send details of their cases to each other, including x-ray results and photographs of wounds, warns research.
Patients are at risk of having their confidentiality breached because up to two-thirds of doctors are using SMS texts and picture messages to share information, including photographs of wounds, in the search for a second opinion.
The findings prompted concern that sensitive details of patients’ conditions could become public if doctors’ phones were lost or stolen or they inadvertently sent a message to a wrong number.
Research among 287 doctors and 564 nurses working at the five hospitals in the Imperial College healthcare NHS trust in London found that 65% of the doctors had used SMS messages to communicate with colleagues about a patient.
The entire article is here.
Tuesday, October 6, 2015
State board proposes discipline for University of Oregon psychologist over record release in rape case
The Associated Press
Originally published September 25, 2015
A state licensing board is proposing a $5,000 fine, a reprimand and ethics training for the head of the University of Oregon’s counseling office.
The proposed discipline, announced Friday, stems from allegations that Shelly Kerr released a student’s counseling records to the UO’s lawyers without the student’s permission. The student sought counseling after she said she was raped by three basketball players.
The rest of the article is here.
Originally published September 25, 2015
A state licensing board is proposing a $5,000 fine, a reprimand and ethics training for the head of the University of Oregon’s counseling office.
The proposed discipline, announced Friday, stems from allegations that Shelly Kerr released a student’s counseling records to the UO’s lawyers without the student’s permission. The student sought counseling after she said she was raped by three basketball players.
The rest of the article is here.
Dignity is a useless concept
It means no more than respect for persons or their autonomy
By Ruth Macklin
BMJ. 2003 Dec 20; 327(7429): 1419–1420.
doi: 10.1136/bmj.327.7429.1419
Appeals to human dignity populate the landscape of medical ethics. Claims that some feature of medical research or practice violates or threatens human dignity abound, often in connection with developments in genetics or reproductive technology. But are such charges coherent? Is dignity a useful concept for an ethical analysis of medical activities? A close inspection of leading examples shows that appeals to dignity are either vague restatements of other, more precise, notions or mere slogans that add nothing to an understanding of the topic.
Possibly the most prominent references to dignity appear in the many international human rights instruments, such as the United Nations' universal declaration of human rights. With few exceptions, these conventions do not address medical treatment or research.
The entire article is here.
By Ruth Macklin
BMJ. 2003 Dec 20; 327(7429): 1419–1420.
doi: 10.1136/bmj.327.7429.1419
Appeals to human dignity populate the landscape of medical ethics. Claims that some feature of medical research or practice violates or threatens human dignity abound, often in connection with developments in genetics or reproductive technology. But are such charges coherent? Is dignity a useful concept for an ethical analysis of medical activities? A close inspection of leading examples shows that appeals to dignity are either vague restatements of other, more precise, notions or mere slogans that add nothing to an understanding of the topic.
Possibly the most prominent references to dignity appear in the many international human rights instruments, such as the United Nations' universal declaration of human rights. With few exceptions, these conventions do not address medical treatment or research.
The entire article is here.
Friday, September 18, 2015
The Devil is in the Details: How Patients' Mental Health Data is at Risk
By Farai Chideya
The Intercept
Aug. 21 2015
Here is an excerpt:
If the effort to blend the efficiency of technology with patients’ privacy needs has backfired in general health care (see “Medical Privacy Under Threat”), it is causing particular emotional and financial wounds in the world of mental health, where even a well-managed diagnosis can become a job-threatening stigma. HIPAA laws, long assumed by patients to protect their privacy, only apply in certain circumstances to certain entities. There’s a raging debate over how to regulate the new privacy issues around employee assistance plans and workplace wellness incentives. And the issue of how and when to track mental health patients has even become an issue at the U.S.-Canada border. Citing the high numbers of Americans who have experienced sexual abuse, major depression, or substance abuse, Dr. Deborah Peel, a psychiatrist who founded Patient Privacy Rights, a research and advocacy group, says, “You cannot force people to cough up information when it’s not private. They will hide it. How can we accept an electronic records system that drives people away from being open and honest?”
The entire article is here.
The Intercept
Aug. 21 2015
Here is an excerpt:
If the effort to blend the efficiency of technology with patients’ privacy needs has backfired in general health care (see “Medical Privacy Under Threat”), it is causing particular emotional and financial wounds in the world of mental health, where even a well-managed diagnosis can become a job-threatening stigma. HIPAA laws, long assumed by patients to protect their privacy, only apply in certain circumstances to certain entities. There’s a raging debate over how to regulate the new privacy issues around employee assistance plans and workplace wellness incentives. And the issue of how and when to track mental health patients has even become an issue at the U.S.-Canada border. Citing the high numbers of Americans who have experienced sexual abuse, major depression, or substance abuse, Dr. Deborah Peel, a psychiatrist who founded Patient Privacy Rights, a research and advocacy group, says, “You cannot force people to cough up information when it’s not private. They will hide it. How can we accept an electronic records system that drives people away from being open and honest?”
The entire article is here.
Monday, September 14, 2015
Record-keeping controversies: Ethical, legal, and clinical challenges
By Ken Pope
Canadian Psychology
Vol. 56(3), August 2015, 348-356
Abstract
The growing array of record-keeping laws, ethical standards, and professional guidelines has created controversy and confusion. Clinicians struggle with what to leave in, what to leave out, how to handle records securely, when to respond to requests for records versus when to refuse, and so on. This article focuses on 5 challenging areas: confidentiality; informed consent; the state, the law, and legal requirements; third-parties; and the implications of research findings for record keeping. It discusses published claims, critiques, proposals for change, and research reports, particularly those of Bemister and Dobson (2011, 2012); Castonguay (2013); Christie, Bemister, and Dobson (2014); Furlong (2013); and Mills (2012). It emphasizes the potential problems with any “1 size fits all” approach and the difficulties in creating sensible regulations that do justice to the diversity of values, contexts, cultures, and theoretical orientations.
The entire article is here.
Canadian Psychology
Vol. 56(3), August 2015, 348-356
Abstract
The growing array of record-keeping laws, ethical standards, and professional guidelines has created controversy and confusion. Clinicians struggle with what to leave in, what to leave out, how to handle records securely, when to respond to requests for records versus when to refuse, and so on. This article focuses on 5 challenging areas: confidentiality; informed consent; the state, the law, and legal requirements; third-parties; and the implications of research findings for record keeping. It discusses published claims, critiques, proposals for change, and research reports, particularly those of Bemister and Dobson (2011, 2012); Castonguay (2013); Christie, Bemister, and Dobson (2014); Furlong (2013); and Mills (2012). It emphasizes the potential problems with any “1 size fits all” approach and the difficulties in creating sensible regulations that do justice to the diversity of values, contexts, cultures, and theoretical orientations.
The entire article is here.
Tuesday, September 8, 2015
Feds oppose UO for releasing alleged gang-rape victim's therapy records
By Richard Read
The Oregonian
Originally published August 20, 2015
A federal official advised universities this week to not share a student's medical records without written consent, contradicting the University of Oregon's release of an alleged gang-rape victim's therapy records to the school's lawyers.
The six-page draft letter from Kathleen Styles, the U.S. Education Department's chief privacy officer, was issued this week after repeated inquiries by The Oregonian/Oregonlive and members of Oregon's congressional delegation.
In effect, the letter steamrolls a UO Counseling Center confidentiality policy weakened in March by center director Shelly Kerr, clinical director Joseph DeWitz and university associate general counsel Samantha Hill. The Oregon Board of Psychologist Examiners is investigating four UO psychologists, including the two center managers, after Kerr secretly gave the woman's records to university attorneys in December without seeking her permission or notifying her therapist, Jennifer Morlok.
The entire article is here.
The Oregonian
Originally published August 20, 2015
A federal official advised universities this week to not share a student's medical records without written consent, contradicting the University of Oregon's release of an alleged gang-rape victim's therapy records to the school's lawyers.
The six-page draft letter from Kathleen Styles, the U.S. Education Department's chief privacy officer, was issued this week after repeated inquiries by The Oregonian/Oregonlive and members of Oregon's congressional delegation.
In effect, the letter steamrolls a UO Counseling Center confidentiality policy weakened in March by center director Shelly Kerr, clinical director Joseph DeWitz and university associate general counsel Samantha Hill. The Oregon Board of Psychologist Examiners is investigating four UO psychologists, including the two center managers, after Kerr secretly gave the woman's records to university attorneys in December without seeking her permission or notifying her therapist, Jennifer Morlok.
The entire article is here.
Sunday, August 16, 2015
Ethical Practice in Telepsychology
By Nicholas Gamble, Christopher Boyle and Zoe A Morris
Special Issue: Telepsychology: Research and Practice
Volume 50, Issue 4, pages 292–298, August 2015
Objective
Telepsychology has the potential to revolutionise the provision of psychological service not only to those in remote locations, or with mobility issues, but also for those who prefer flexible access to services. Rapid developments in internet communications technology have yielded new and diverse methods of telepsychology. As a result, ethical regulatory and advisory guidelines for practice have often been developed and disseminated reactively. This article investigates how the core ethical principles of confidentially, consent and competence are challenged in telepsychological practice.
Method
Through the application of existing ethical standards, advances in communications technology are considered and their ethical use in psychological contexts explored.
Conclusion
It is expected that psychologists will have basic competencies for the use of everyday technology in their practice. However, the use of internet communications technology for telepsychology has created new opportunities and challenges for ethical practice. For example, telepsychology is geographically flexible, but there can be privacy concerns in cross-border information flow. Psychologists who engage in telepsychology require a particularly thorough understanding of concepts such as data mining, electronic storage, and internet infrastructure. This article highlights how existing technology and communication tools both challenge and support ethical practice in telepsychology in an Australian regulatory context.
The entire article is here.
Special Issue: Telepsychology: Research and Practice
Volume 50, Issue 4, pages 292–298, August 2015
Objective
Telepsychology has the potential to revolutionise the provision of psychological service not only to those in remote locations, or with mobility issues, but also for those who prefer flexible access to services. Rapid developments in internet communications technology have yielded new and diverse methods of telepsychology. As a result, ethical regulatory and advisory guidelines for practice have often been developed and disseminated reactively. This article investigates how the core ethical principles of confidentially, consent and competence are challenged in telepsychological practice.
Method
Through the application of existing ethical standards, advances in communications technology are considered and their ethical use in psychological contexts explored.
Conclusion
It is expected that psychologists will have basic competencies for the use of everyday technology in their practice. However, the use of internet communications technology for telepsychology has created new opportunities and challenges for ethical practice. For example, telepsychology is geographically flexible, but there can be privacy concerns in cross-border information flow. Psychologists who engage in telepsychology require a particularly thorough understanding of concepts such as data mining, electronic storage, and internet infrastructure. This article highlights how existing technology and communication tools both challenge and support ethical practice in telepsychology in an Australian regulatory context.
The entire article is here.
Tuesday, June 23, 2015
UO whistleblowers: giving student's confidential therapy records to campus lawyers felt wrong
By Richard Read
The Oregonian
Originally posted June 4, 2015
The executive assistant to the director of the University of Oregon's Counseling Center disobeyed instructions last December and showed a therapist a confidential email from their boss.
The email's directions horrified both Karen Stokes, the director's assistant, and Jennifer Morlok, the clinician.
Shelly Kerr, the center's director, told Stokes in the Dec. 8, 2014, message to give the university's legal office a client's entire case file -- including notes taken by Morlok during private therapy sessions.
The client was a UO freshman who says she was gang raped multiple times on March 8, 2014, by three members of the men's basketball team.
Normally mental-health professionals go to great lengths, even in the face of court orders, to release as little information about clients as possible. Clinicians want patients to feel safe expressing their most intimate thoughts and feelings during therapy.
The entire article is here.
The Oregonian
Originally posted June 4, 2015
The executive assistant to the director of the University of Oregon's Counseling Center disobeyed instructions last December and showed a therapist a confidential email from their boss.
The email's directions horrified both Karen Stokes, the director's assistant, and Jennifer Morlok, the clinician.
Shelly Kerr, the center's director, told Stokes in the Dec. 8, 2014, message to give the university's legal office a client's entire case file -- including notes taken by Morlok during private therapy sessions.
The client was a UO freshman who says she was gang raped multiple times on March 8, 2014, by three members of the men's basketball team.
Normally mental-health professionals go to great lengths, even in the face of court orders, to release as little information about clients as possible. Clinicians want patients to feel safe expressing their most intimate thoughts and feelings during therapy.
The entire article is here.
Tuesday, June 9, 2015
Danger: Electronic Records Ahead
By Stephen A. Ragusea, Psy. D., ABPP
The National Psychologist
Some 30 years ago, I was building a psychiatric hospital in central Pennsylvania and we discussed the possibility of starting-up the new facility’s operation with all electronic records. It was the early days of computer use but it seemed like a good idea at the time. Ultimately, we decided against the plan because we couldn’t find a technical mechanism to guaranty the security of patient records against the threat of unauthorized access.
That was a long time ago.
The truth is that not much has changed in the last three decades regarding computer security, except for one thing: Our society seems to have decided that open health records are more important than confidentiality.
As a society, we not only keep our records electronically, but we increasingly are making those records available to anybody with a password. There are real advantages to that kind of system for cardiac patients in crisis. But, making psychological records available in such a system would scare the hell out of me; it would be extraordinarily dangerous and fraught with unintended consequences.
The entire article is here.
The National Psychologist
Some 30 years ago, I was building a psychiatric hospital in central Pennsylvania and we discussed the possibility of starting-up the new facility’s operation with all electronic records. It was the early days of computer use but it seemed like a good idea at the time. Ultimately, we decided against the plan because we couldn’t find a technical mechanism to guaranty the security of patient records against the threat of unauthorized access.
That was a long time ago.
The truth is that not much has changed in the last three decades regarding computer security, except for one thing: Our society seems to have decided that open health records are more important than confidentiality.
As a society, we not only keep our records electronically, but we increasingly are making those records available to anybody with a password. There are real advantages to that kind of system for cardiac patients in crisis. But, making psychological records available in such a system would scare the hell out of me; it would be extraordinarily dangerous and fraught with unintended consequences.
The entire article is here.
Friday, June 5, 2015
Ethical issues in researching daily life
Researchers who conduct ambulatory assessment should be aware of the pitfalls that may come with new technology that captures participant data.
By Timothy J. Trull, PhD
The Monitor on Psychology
April 2015, Vol 46, No. 4
Print version: page 70
Here is an excerpt:
With this increased utility comes a parallel increase in both ethical issues and assessment challenges. They include:
Informed consent. As with all forms of assessment, it is necessary to ensure that ambulatory assessment participants are informed about the procedures or protocol of the study, the exact nature of the data to be collected, and potential risks and burdens related to the study. Several unique features of ambulatory assessment should be considered. First, especially because ambulatory assessment may involve passive data collection, it is vital to make the participant aware of all of the data that are being collected, as well as how these data might be used. It is also important to recognize that ambulatory assessment may unintentionally capture data on nonconsenting people who interact with the participant via audio recordings, videos or photos. Investigators must decide ahead of time how this should be handled. Should people be encouraged to discuss their participation in the ambulatory assessment study with others with whom they have contact? Some U.S. states may forbid the recording of third parties without their permission. Participants should be given the option to stop recording at any point and to review their data if recording has occurred in sensitive situations.
The entire article is here.
By Timothy J. Trull, PhD
The Monitor on Psychology
April 2015, Vol 46, No. 4
Print version: page 70
Here is an excerpt:
With this increased utility comes a parallel increase in both ethical issues and assessment challenges. They include:
Informed consent. As with all forms of assessment, it is necessary to ensure that ambulatory assessment participants are informed about the procedures or protocol of the study, the exact nature of the data to be collected, and potential risks and burdens related to the study. Several unique features of ambulatory assessment should be considered. First, especially because ambulatory assessment may involve passive data collection, it is vital to make the participant aware of all of the data that are being collected, as well as how these data might be used. It is also important to recognize that ambulatory assessment may unintentionally capture data on nonconsenting people who interact with the participant via audio recordings, videos or photos. Investigators must decide ahead of time how this should be handled. Should people be encouraged to discuss their participation in the ambulatory assessment study with others with whom they have contact? Some U.S. states may forbid the recording of third parties without their permission. Participants should be given the option to stop recording at any point and to review their data if recording has occurred in sensitive situations.
The entire article is here.
Thursday, May 28, 2015
Tarasoff's catch-22.
By Stephen R. Huey
The American Psychologist
2015 Apr;70(3):284-5. doi: 10.1037/a0039064
Abstract
Comments on the article by D. N. Bersoff (see record 2014-28692-002). Bersoff poses a much-needed challenge to the rationale of laws based on Tarasoff v. Regents of the University of California (1976), which exist in most states and require therapists to warn the intended victim, police, and/or others when a patient voices serious threats of violence. If Tarasoff-related laws were ever to be modified, research support would be required. To begin with, what is the experience of other countries that happen to address this issue differently and of the seven states that, according to Bersoff, have not adopted Tarasoff-related requirements? Another question is whether patients who are unwilling to invite the consequences of therapist disclosure ever reveal reportable intentions to their therapists anyway-say, by mistake or impulse-thus making current law marginally useful? Rules that undercut sacrosanct confidentiality create a catch-22 in which the indisputable ethical necessity of informed consent has an unintended consequence- namely, therapy is preceded by informed consent but precluded by it.
The entire article is here.
The American Psychologist
2015 Apr;70(3):284-5. doi: 10.1037/a0039064
Abstract
Comments on the article by D. N. Bersoff (see record 2014-28692-002). Bersoff poses a much-needed challenge to the rationale of laws based on Tarasoff v. Regents of the University of California (1976), which exist in most states and require therapists to warn the intended victim, police, and/or others when a patient voices serious threats of violence. If Tarasoff-related laws were ever to be modified, research support would be required. To begin with, what is the experience of other countries that happen to address this issue differently and of the seven states that, according to Bersoff, have not adopted Tarasoff-related requirements? Another question is whether patients who are unwilling to invite the consequences of therapist disclosure ever reveal reportable intentions to their therapists anyway-say, by mistake or impulse-thus making current law marginally useful? Rules that undercut sacrosanct confidentiality create a catch-22 in which the indisputable ethical necessity of informed consent has an unintended consequence- namely, therapy is preceded by informed consent but precluded by it.
The entire article is here.
Tuesday, May 26, 2015
University of Oregon Employees Under Investigation for Misconduct in Rape Case
By Richard Read
The Oregonian
Originally posted May 8, 2015
Six University of Oregon employees, including a vice president and the school's interim top lawyer, are under investigation for alleged misconduct in the handling of therapy records of a student who says she was gang-raped by three Ducks basketball players.
The Oregon State Bar is investigating complaints against interim general counsel Douglas Park and associate general counsel Samantha Hill. The Oregon Board of Psychologist Examiners is investigating complaints against four people, including Robin Holmes, the university's vice president for student life, who is a licensed psychologist.
Jennifer Morlok, a senior staff therapist identified in legal correspondence as the clinician who counseled the woman, filed all the complaints.
The entire article is here.
The Oregonian
Originally posted May 8, 2015
Six University of Oregon employees, including a vice president and the school's interim top lawyer, are under investigation for alleged misconduct in the handling of therapy records of a student who says she was gang-raped by three Ducks basketball players.
The Oregon State Bar is investigating complaints against interim general counsel Douglas Park and associate general counsel Samantha Hill. The Oregon Board of Psychologist Examiners is investigating complaints against four people, including Robin Holmes, the university's vice president for student life, who is a licensed psychologist.
Jennifer Morlok, a senior staff therapist identified in legal correspondence as the clinician who counseled the woman, filed all the complaints.
The entire article is here.
Thursday, April 9, 2015
Controversy Continues at University of Oregon Counseling Center
By Richard Read
The Oregonian
Originally published April 8, 2015
Here is an excerpt:
Bronet assured students in a March 20 memo that UO's counseling center would keep records confidential barring extraordinary circumstances. She urged them to use university mental-health services without fear.
Meanwhile, The Oregonian/OregonLive has learned, the head of the University Counseling and Testing Center significantly weakened confidentiality safeguards in a policy statement she wrote with UO's legal department.
Director Shelly Kerr wrote in an internal April 3 email obtained by the news organization that she worked with university attorneys to draft the new confidentiality policy. "I want to be sure that the information on our web and printed materials are as clear and accurate as possible," she wrote.
But the new policy, already in effect, contradicts promises Bronet made and greatly expands the number of exceptions that could be cited as justification to break confidentiality.
The entire article is here.
The Oregonian
Originally published April 8, 2015
Here is an excerpt:
Bronet assured students in a March 20 memo that UO's counseling center would keep records confidential barring extraordinary circumstances. She urged them to use university mental-health services without fear.
Meanwhile, The Oregonian/OregonLive has learned, the head of the University Counseling and Testing Center significantly weakened confidentiality safeguards in a policy statement she wrote with UO's legal department.
Director Shelly Kerr wrote in an internal April 3 email obtained by the news organization that she worked with university attorneys to draft the new confidentiality policy. "I want to be sure that the information on our web and printed materials are as clear and accurate as possible," she wrote.
But the new policy, already in effect, contradicts promises Bronet made and greatly expands the number of exceptions that could be cited as justification to break confidentiality.
The entire article is here.
Tuesday, April 7, 2015
Healthcare Accounted For Almost Half Of 2014 Client Breaches
By Christine Kern
Health IT Outcomes
Originally published March 12, 2015
A Kroll study has found the healthcare industry accounted for 49 percent of the company’s “client events” during 2014, followed by business services (retail, insurance, and financial services) at 26 percent, and higher education at 11 percent. The study further found malicious intent breach events increased while those caused by human error declined.
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