Private patient

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Reply Thu 15 Apr, 2010 07:35 pm
Do you think medical records should be a matter of public domain?

What are your feelings about your medical history being shared with the public?

Do you think by letting someone know your ills gives them a better understanding of who and what you are?

Does this knowledge bring you closer or separate you?

When should such things be reserved for family and friends and doctors alone?

Do you have a duty to others by informing them of your deformities?

Are they better off as a secret or as a gossip for them or yourself?
 
wayne
 
Reply Thu 15 Apr, 2010 08:17 pm
@sometime sun,
I most definitely think medical records should be a private matter.

In the natural world any sign of weakness is an open invitation to predators. It would be nice if humans were removed from that, but it just isn't so. We deserve the personal right to decide for ourselves who we trust with our infirmities.

I think most of us prefer to keep our weaknesses private, although there are those who like to wear theirs on their sleeve.

We can trust people with our faults in a healthy and constructive manner, but it does get used in an unhealthy, attention seeking , manner by some people.

I think it is healthy to share the fact that I have weakness, but only when I can also show the strength to overcome it.
 
VideCorSpoon
 
Reply Thu 15 Apr, 2010 11:12 pm
@wayne,
As far as medical records being available in the public domain, that would be a serious breach of constitutional rights (I suppose as far as US citizens would be concerned). It's been (and as far as I am aware) still a big deal for third parties removed from the patient to have access to medical records, let alone have just anyone have access to them. Suppose your employer got a hold of your medical records and found out that you had a certain disease or disability that would harm your chances of getting a job (which should be based on capability and merit to perform the given job). What about neighbors, landlords, etc. It's a huge can of worms that should never be opened.

Would letting someone know of your ills give them a better understanding of yourself? Maybe. But the most important thing is that that information be a voluntary transference of your own sensitive information. Disclosure is a definitely a problematic part of bioethics. Even besides the issues with family knowing your medical history, they are nothing compared with some of the potential complications with full disclosure of illness between patients and doctors. For example, there are some illnesses which a doctor is not allowed to tell the patient they have because of the very real danger of that patient committing suicide.
 
jeeprs
 
Reply Fri 16 Apr, 2010 03:34 am
@sometime sun,
few things would be, or should be, more confidential, than medical data. Apart from anything else, medical information needs to be interpreted by those qualified to do so. In the wrong hands, right information instantly becomes misinformation. I can't see any benefit whatever in putting it in the public domain.
 
salima
 
Reply Fri 16 Apr, 2010 08:19 am
@sometime sun,
i would like to be able to access my own medical records for sure, and i havent been able to in the past, and sometimes had to pay a lot of money for copies. besides medical records there are all kinds of information that is available to the government and the public which i am not in favor of. for instance, the house where i lived there is a record easily available on the web that shows the names of sellers and buyers or on the deed etc. police records are also easily accessible on the web. i dont like that.
 
VideCorSpoon
 
Reply Fri 16 Apr, 2010 09:07 am
@salima,
I think another issue (which probably many of you have experienced as well) is that the patient should at least have definite ownership over their own medical records and all pertaining media (like x-rays, etc). For example, in some cases (not all of them of course) suppose you had x-rays done at one office, and then went to another doctor who was then told that the other doctor would not release those x-rays because of the change in business. In my case, this was for a chiropractor though, so the x-rays were not vital, but still, it's a pain (and dangerous) to do things like x-rays more than you have to. But seriously, you pay for it, it's an x-ray of your body, etc. Where is the line of ownership?

Another issue I was just thinking of too is the restricted rights doctors have towards releasing information to you. For example, suppose you go to the doctor with the express intention of discussing x, and then you bring up another topic relating to y. Technically, the doctor is not allowed to discuss y with you, not because they do not want to, but because the insurance company will not let them discuss it. You would have to make a separate appointment. Now that there is health care "reform," maybe that will change.
 
sometime sun
 
Reply Fri 16 Apr, 2010 06:43 pm
@VideCorSpoon,
Should we be embarrassed about our weaknesses?

Is a mental disability more or less prejudiced against than a physical one?

Is a mental one worse because it is more easily disguised than a physical one?

Is not a mental one worse because we can deny it and hide from it?
 
mister kitten
 
Reply Fri 16 Apr, 2010 07:40 pm
@sometime sun,
What if I invented an infinite supply of medicine-medicine that keeps people alive forever. Would the documents be a problem then?

I wouldn't want any of my medicine. That would be cheating.
 
PappasNick
 
Reply Fri 16 Apr, 2010 08:08 pm
@VideCorSpoon,
VideCorSpoon;152647 wrote:
Even besides the issues with family knowing your medical history, they are nothing compared with some of the potential complications with full disclosure of illness between patients and doctors. For example, there are some illnesses which a doctor is not allowed to tell the patient they have because of the very real danger of that patient committing suicide.


What illnesses are these? And when you say the doctor is not allowed to tell the patient, what is it that prevents him? Thank you.
 
wayne
 
Reply Fri 16 Apr, 2010 09:47 pm
@sometime sun,
sometime sun;153024 wrote:
Should we be embarrassed about our weaknesses?

Is a mental disability more or less prejudiced against than a physical one?

Is a mental one worse because it is more easily disguised than a physical one?

Is not a mental one worse because we can deny it and hide from it?


I don't think we should ever be embarrassed by our weaknesses. We can often use them to demonstrate our strength to another, who might gain strength from us.

Mental illnesses have become somewhat less stigmatized in recent years, even so ,one must be careful about this. Often ,our openess can benefit others if we can demonstrate our ability to overcome our illness. I think our purpose for revealing ourselves should always be selfless in nature rather than selfish.
 
VideCorSpoon
 
Reply Fri 16 Apr, 2010 10:54 pm
@PappasNick,
PappasNick;153047 wrote:
What illnesses are these? And when you say the doctor is not allowed to tell the patient, what is it that prevents him? Thank you.


Some of the diseases that I was alluding to are very vicious neuro-degenerative diseases such as Huntington's disease. Essentially, for those diagnosed with the unfortunate disease, a major effect is essentially the catastrophic loss of cognitive (and motor) function. So, if diagnosed, you are certain to begin to deteriorate in middle age and slowly descend into madness.

And especially with Huntington's disease, there is an extremely high rate of suicide for those in various stages of the disease. For example, earlier stages average around 13% in completed suicide (not including attempted suicide), while in the latter stages, it can be as much as 25%. Suffice to say that of those who commit suicide due to the disease, a little less than half of those who do commit suicide do so before the symptoms ever begin to manifest.

Now just to digest all of this. The disease does not begin to show the inherent symptoms until roughly middle age (of course not accounting for the statistical outliers). However, when children of parents who have the disease submit for genetic testing, they may be as young as their early teens. What can you imagine happens when a young adult learns that they are the recipient of an inevitable neuro-degenerative disease which will certainly result in madness later in their life? Honestly, it makes me sweat just thinking about it.

So, a portion of those who are told that they will certainly suffer from the disease later in life commit suicide (for whatever reasons they have) even before it effects them. In fact, those diagnosed with Huntington's disease are among the diseases with the highest suicide rates.

There is this wonderful (albeit horrible in the grander context) article by David Thomasma entitled Telling the Truth to Patients: A Clinical Ethics Exploration, which explores the lurking negative effects of practitioner's commitment to truth (in the form of rights, utility, and kindness). Indeed, in an example somewhat like Huntington's disease, Thomasma explains that truth is, a) contextual in so far as the relationship of the doctor and the patient (i.e. the doctors discretion as to whether or not to reveal the information to the patient, etc). Also, b) truth (i.e. telling the patient that they have Huntington's for example) is a secondary good, secondary only to the survival of the individual and the community. And c) truth is primarily inherent in the healing of an illness, so that if withholding the truth from a patient means they may live a bit longer (and not risk the possibility of suicide), it is better just not to tell the patient at all.

So the doctor who is not allowed to tell the patient they have a disease such as Huntington is restricted by a very complex bioethical framework of non-normative meta-ethics. And as to what exactly prevents the doctor from telling the patient, there are (whether that be fortunate or unfortunate to the patient) liberty limiting principles that have substantiated precedence under common (and civil) law. For example, the second foremost principle, the principle of paternalism, dictates that a person's liberty and rights are justifiably restricted in order to prevent harm to the person (by themselves or others). It is a fine line I do say, but it is the slippery slope of bioethics.

Your welcome. (lol)
 
sometime sun
 
Reply Sat 17 Apr, 2010 06:40 pm
@wayne,
wayne;152582 wrote:

In the natural world any sign of weakness is an open invitation to predators. It would be nice if humans were removed from that, but it just isn't so. We deserve the personal right to decide for ourselves who we trust with our infirmities.

What if the patient is the predator?
What if they are psychotic?
Is it not in the best interest of both patient and public to know their infirmity is known?
If not more room to be helped, some people need more help.
What of Aids? should there not be a warning label?
I knew this guy who had tattooed a big + positive sign on his arm.
I think that was brave of him but also very responsible.

---------- Post added 04-18-2010 at 01:43 AM ----------

VideCorSpoon;152647 wrote:
For example, there are some illnesses which a doctor is not allowed to tell the patient they have because of the very real danger of that patient committing suicide.

What if the deformity is a suicidal tendancy, should it not be better known someone is sensitive?
Or is there such a thing as to much medicine?

---------- Post added 04-18-2010 at 01:50 AM ----------

VideCorSpoon;152778 wrote:
I think another issue (which probably many of you have experienced as well) is that the patient should at least have definite ownership over their own medical records and all pertaining media (like x-rays, etc). For example, in some cases (not all of them of course) suppose you had x-rays done at one office, and then went to another doctor who was then told that the other doctor would not release those x-rays because of the change in business. In my case, this was for a chiropractor though, so the x-rays were not vital, but still, it's a pain (and dangerous) to do things like x-rays more than you have to. But seriously, you pay for it, it's an x-ray of your body, etc. Where is the line of ownership?

Another issue I was just thinking of too is the restricted rights doctors have towards releasing information to you. For example, suppose you go to the doctor with the express intention of discussing x, and then you bring up another topic relating to y. Technically, the doctor is not allowed to discuss y with you, not because they do not want to, but because the insurance company will not let them discuss it. You would have to make a separate appointment. Now that there is health care "reform," maybe that will change.

Paying the devil not to harm you.
You cant insure the trustless.

---------- Post added 04-18-2010 at 01:52 AM ----------

mister kitten;153044 wrote:
What if I invented an infinite supply of medicine-medicine that keeps people alive forever. Would the documents be a problem then?

I wouldn't want any of my medicine. That would be cheating.

No but you may still have to pay the premiums.

---------- Post added 04-18-2010 at 02:00 AM ----------

Cannot treatment be the bigger disease?

I know some people who are addicted to their illness.
Is their such a thing as to much information or attention?
 
VideCorSpoon
 
Reply Sat 17 Apr, 2010 07:30 pm
@sometime sun,
sometime sun;153324 wrote:


What if the deformity is a suicidal tendancy, should it not be better known someone is sensitive?
Or is there such a thing as to much medicine?


Who said that suicide was a deformity? There are some cultures that look at suicide as a somewhat honorable act rather than a cowardly end. Honestly, suicide is relative to the society in which the act occurs... in some cases incredibly mixed. St. Thomas Aquinas stated in Summa Theologica (specifically II. ii, q.64, Art 5) that suicide was unacceptable for under the three reasons he stated, whether that be natural thing keep themselves in being, communal obligation, crime against Gods law. However, you have David Hume among a few others stated that suicide was honorable and sometimes praiseworthy if the balance obtained from the action produced more benefit for the society. Something I think Aquinas may have had some minimal agreement with. It just so happens that modern jurisprudence developed along the lines of Aquinas' conception of suicide (specifically outlined in Blackstone's commentaries) into present day common law. The notion of suicide and suicidal tendency are relative. Common law currently recognizes Aquinas, but maybe Hume tomorrow.

Now with all of that taken into account, you have whole pandora's boxes of arguments for right to life and right to death (like euthanasia, etc.). And as I had mentioned in a previous post, the principle of paternalism is such that there is a constant flux of right, obligation, etc. which have precedence over the individuals will. If a patient is suicidal in so far as they are suicidal without any medical grounds (which would be difficult to prove), then I would suppose it falls on the scales of rationality and the law. But then, should they be labeled suicidal the way another is labeled a pedophile or a criminal. As a sad commentary on the way we live now, people are seldom abstract thinkers in those regards and look with suspicion and liability at anyone with strings attached. Common knowledge of suicidal tendency would be disastrous for the individual.

sometime sun;153324 wrote:

Paying the devil not to harm you.
You cant insure the trustless.
 
sometime sun
 
Reply Sat 17 Apr, 2010 08:08 pm
@VideCorSpoon,
VideCorSpoon; Suicidal tendancy (emphasis on the tendancy) can often be more a public affair, what do they call those who want to die by arms?
Those people who force the trigger of the officer?
 
wayne
 
Reply Sat 17 Apr, 2010 08:59 pm
@sometime sun,
We must be careful not to convict the innocent.
Everyone has a right to deal with their infirmities on their own terms.
If this means societal imperfections, so be it.
There is no utopia, we can only do our best.
 
Pepijn Sweep
 
Reply Sun 18 Apr, 2010 12:01 am
@salima,
salima;152756 wrote:
i would like to be able to access my own medical records for sure, and i havent been able to in the past, and sometimes had to pay a lot of money for copies. besides medical records there are all kinds of information that is available to the government and the public which i am not in favor of. for instance, the house where i lived there is a record easily available on the web that shows the names of sellers and buyers or on the deed etc. police records are also easily accessible on the web. i dont like that.


I am not sure what to think about it. I think it's strange anyone can access my private information; on the other hand, what is private ? Internet changed the possibilities for anonymous gathering of information which I do not agree with.

I like to share with people, but I like to know who I share with. Putting a recipe on-line is one thing, people cooking in my kitchen is another. Why should everything be public ? The original reasons (business & government purposes) for public records were to have reliable information; now it's often curiosity of people who can easily draw the wrong conclusions.
 
 

 
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