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What is Legal: Healthcare Privacy?
Hippocratic Oath: "...Whatever, in the course of my practice, I may see or hear (even when not invited),
whatever I may happen to obtain knowledge of, if it be not proper to repeat it, I will keep sacred and secret
within my own breast..." (Circa 400 BC)
Proverbs 20:19 "A gossip betrays a confidence; so avoid anyone who talks too much."
Legal duty to warn or report (credible threats against identifiable persons, suspicion of harm to vulnerable
children, elders, etc).
HIPAA - mainly written to facilitate insurance companies sharing electronic medical records - privacy provisions
added to alleviate public concern. Certain categories of people can gain access to medical records "to do their jobs"
without patient signing a records release form. For example, AHCCCS has in the past demanded that Dr. Weyrich
release medical records to them without a signed records release from the patients. In addition, many
insurance companies, including AHCCCS, can require prior authorization, which in turn requires the doctor
providing medical records to support the authorization requested.
However, private pay patients can request that their doctor NOT release any records without either their
signed consent, or a court order.
Does requiring a person to disclose their vaccination or natural immunity status violate that person's privacy?
Violation of a person's privacy is a kind of violation of the person's autonomy ... as discussed in the next topic.
What is Ethical: Autonomy
According to the textbook "Medical Ethics and the Humanities" by Paola, the concept of "autonomy" arose out of Greek
culture and philosophy, and is now an important part of Western culture, [and a foundation of the classical liberal
philosophy that shaped the founding of the United States.]
Basically, autonomy means that each individual has the freedom to act in ways that are consistent with their own
beliefs, as long as exercising that freedom does not interfere with the equal freedom of others to act according to
their own beliefs.
This can be paraphrased as "your right to swing your arms ends where my nose begins" or "my body, my choice."
In the medical world, an important part of a person's autonomy is called the right of informed consent. This means
that a patient has the right to be told all known material facts about a procedure (RISKS, benefits, and ALTERNATIVES)
before agreeing to any particular treatment.
Another expression of the principle of autonomy and informed consent is the Libertarian "Non-aggression principle,"
which prohibits the initiation of force or fraud against any individual (or group). Obviously, using force to coerce someone
violates the person's autonomy; and fraud is a form of violating informed consent by knowingly providing
incorrect or incomplete information to obtain consent.
In an interesting case out of India, the manufacturer and
certain corporate sponsors, including Bill Gates, are being charged in India's supreme court with the allegation
that a person who died after receiving the COVID vaccine was not given proper informed consent of the RISKS.
In India this constitutes a capital offense.
Another example of violating the principle of autonomy occurs when an individual, group, or company
attempts to coerce a person to take an action by presenting fraudulent information. Again, fraudulent
information is anything presented as the "truth, the whole truth, and nothing but the truth," while knowing
that the truth is incomplete. Would this occur if the mainstream media and big tech
"cancels" or "shadow bans" anyone who discusses possible RISKS or ALTERNATIVE treatments?
Coming back full circle here, "informed consent," which is foundational to the principle of autonomy, depends
on full disclosure of the RISKS, benefits, and ALTERNATIVES). Tobacco and pharmaceutical companies have been
punished by the courts for not sharing known risks of their products (e.g. opiates) with consumers.
Does this include vaccines?
Other cases of violation of informed consent include Nazi research on prisoners (force), and the Tuskegee
cohort study of syphilis (not informed of alternative treatments).
Coming back to the medical world, paternalism is considered to be a violation of patient autonomy. This
occurs for example when "doctor knows best" and forces a treatment on a patient for "the patient's own good."
In the political world, "paternalism" takes the form of "I am the enlightened ruling elite/scientist,
and I know what is best for you. Don't argue, just take your medicine." If this is wrong in medicine, how can it
be right in politics?
On the other hand, the patient cannot force a doctor to provide a treatment that violates the doctor's oath
"to do no harm" or is otherwise inappropriate, again because the doctor has equal right to autonomy, as does the patient.
Other points for discussion: "When does my body, my choice apply?"
When the person is told what substances they can or cannot ingest (e.g. drugs, alcohol) or what substances they
must ingest (vaccines), does that violate a person's autonomy?
The counter-argument is also interesting: can society tell you what to do with your body, if your actions
might affect other persons? For example, if failure to be vaccinated can cause someone else to be infected?
Or in the case of pregnancy, many persons believe there are two lives at stake, and both must be protected
from the initiation of force or fraud?
What consistent rule can we formulate that applies equally to all these cases? (We will discuss this point
further next week, when we consider Kant's Categorical Imperative).