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washington US Senate weighs proposal on medical privacy
DISPATCH
WASHINGTON
US Senate weighs proposal on medical privacy
dropping the Clinton consent rules, one-time notification that the patient’s veryone is in favour of protecting which it warned would delay patients’ information may be delivered to the confidentiality of personal care without enhancing privacy. “For others. medical records. Nonetheless, hospitals”, the association stated, “the “The primary reason a patient goes strange alliances and odd confrontaanswer is clear: the written consent to the doctor is for care not privacy”, tions are forming on Capitol Hill, as requirement will frustrate patients Claude Allen, Deputy Secretary of the White House moves towards and providers to no necessary end”. the Department of Health and implementation of the fine adminisOn the other hand, Human Services, said at trative details for guarding of these the American a hearing on April 16, records against prying eyes and comPsychiatric Assocwhich was chaired by mercial exploitation. iation (APA), with Senator Ted Kennedy, Without ever coming to complea membership of the leading liberal in US tion, the quest for medical-privacy 38 000 physicians, Congress. At the hearrules has had an assured place on the Rights were not adamantly declared ing, Kennedy invoked political agenda since 1996, when granted to include its opposition to any the Internet monster, Congress declared the need for this image in relaxation of safedeclaring that “with the medical-data security in the new era electronic media. guards for patients’ click of a mouse”, of electronic record-keeping. Howrecords. “It appears patients’ records “can ever, several deadlines for final rules Please refer to the that others have misbe launched into have come and gone, as conflict has printed journal. placed their moral cyberspace for millions intensified over the proper balance compass—prior conto see”, including between protection of the records sent is an essential “employers and peeping and making them accessible for tool used to protect toms”. patients’ care and health education, patients”, the associAllied with Kennedy research, and public-health surveilation asserted in a in opposition to the Senator Ted Kennedy lance. statement. Testifying Bush proposal is Lurking in the background is the at Kennedy’s hearing, APA President Republican Donald Barr, who was booming business of direct medical Richard Harding, professor of clinical recently rated 100% ideologically marketing to patients who are psychiatry and paediatrics at the pure by the American Conservative known to have specific afflictions, or University of South Carolina School Union and a “foremost defender” of who could be encouraged into thinkof Medicine, denounced the gun ownership by the National Rifle ing they might. There is also proposed switch from consent to Association. The strange bed-fellows concern about the illicit use of mednotification. “The elimination of the were joined by ical information consent requirement is a significant the ultra-liberal for screening jobchange not only to the historic seekers, and for “the medical privacy issue has American Civil doctor–patient relationship”, he said, Liberties Union, personal vendetlong remained unresolved, “but also an impediment to physitas. Companies and is gingerly approached by which termed the cians’ efforts to provide the best that offer to wise politicians in this year of Bush plan a medical care”. “rollback in prodredge up perCongressional elections” Citing an example not unfamiliar tection”, adding sonal information to some of the denizens of Capitol that “the touchfor modest fees Hill, Harding noted that “celebrities stone of medical records privacy is have become a fixture on the who seek help from a substance patient consent”. Internet. abuse centre and pay in cash to be Strong support for the Bush proOpponents contend that the Bush anonymous should be allowed to do posal—though with urgings towards proposal, scheduled to take effect in so without their health information even greater access to patients’ April, 2003, is a giveaway to medical being released. Similarly, Medicare records—was expressed by the marketing companies, and generally patients who elect personally to pay Washington-based medical school lowers the barriers to misuse of perfor treatment should not be at risk lobby, the Association of American sonal health information. The presifrom the prying eyes of government.” Medical Colleges (AAMC), which dent’s team insists that their scheme For several reasons, including pophas otherwise frequently clashed with simplifies proposed regulations inherular fears that bootlegged medical the White House on financial matters ited from the Clinton administration, information can adversely affect and restrictions on research involving and would speed access to health care employment prospects, the medical stem cells, plus other biomedical without risk to privacy. The Clinton privacy issue has long remained unrepolicy issues. Announcing its “strong plan required physicians to obtain solved, and is gingerly approached by endorsement”, the AAMC said the their patients’ explicit consent before wise politicians in this year of President’s proposal “moves substanrevealing anything about them to anyCongressional elections. Privacy protially toward restoration of the one, including other medical personvokes public concern more than any necessary balance between medical nel, pharmacists, and insurers. other issue, Senator Christopher privacy and other equally important Officials of the Bush administration Dodd said at Kennedy’s hearing. public interests, including quality argue that the consent requirement is The fate of this latest attempt to health care and research-related needlessly cumbersome, and would fulfil the 1996 mandate for medicaladvances in treatment and prevenentail delays for repeated consent signprivacy rules remains uncertain. tion”. Representing nearly 5000 ings as a patient moves through the hospitals, the American Hospital medical system. When a patient Association came out solidly for arrives for care, Bush would utilise a Daniel S Greenberg AP
E
THE LANCET • Vol 359 • May 4, 2002 • www.thelancet.com
1585
For personal use. Only reproduce with permission from The Lancet publishing Group.
WASHINGTON
US Senate weighs proposal on medical privacy
dropping the Clinton consent rules, one-time notification that the patient’s veryone is in favour of protecting which it warned would delay patients’ information may be delivered to the confidentiality of personal care without enhancing privacy. “For others. medical records. Nonetheless, hospitals”, the association stated, “the “The primary reason a patient goes strange alliances and odd confrontaanswer is clear: the written consent to the doctor is for care not privacy”, tions are forming on Capitol Hill, as requirement will frustrate patients Claude Allen, Deputy Secretary of the White House moves towards and providers to no necessary end”. the Department of Health and implementation of the fine adminisOn the other hand, Human Services, said at trative details for guarding of these the American a hearing on April 16, records against prying eyes and comPsychiatric Assocwhich was chaired by mercial exploitation. iation (APA), with Senator Ted Kennedy, Without ever coming to complea membership of the leading liberal in US tion, the quest for medical-privacy 38 000 physicians, Congress. At the hearrules has had an assured place on the Rights were not adamantly declared ing, Kennedy invoked political agenda since 1996, when granted to include its opposition to any the Internet monster, Congress declared the need for this image in relaxation of safedeclaring that “with the medical-data security in the new era electronic media. guards for patients’ click of a mouse”, of electronic record-keeping. Howrecords. “It appears patients’ records “can ever, several deadlines for final rules Please refer to the that others have misbe launched into have come and gone, as conflict has printed journal. placed their moral cyberspace for millions intensified over the proper balance compass—prior conto see”, including between protection of the records sent is an essential “employers and peeping and making them accessible for tool used to protect toms”. patients’ care and health education, patients”, the associAllied with Kennedy research, and public-health surveilation asserted in a in opposition to the Senator Ted Kennedy lance. statement. Testifying Bush proposal is Lurking in the background is the at Kennedy’s hearing, APA President Republican Donald Barr, who was booming business of direct medical Richard Harding, professor of clinical recently rated 100% ideologically marketing to patients who are psychiatry and paediatrics at the pure by the American Conservative known to have specific afflictions, or University of South Carolina School Union and a “foremost defender” of who could be encouraged into thinkof Medicine, denounced the gun ownership by the National Rifle ing they might. There is also proposed switch from consent to Association. The strange bed-fellows concern about the illicit use of mednotification. “The elimination of the were joined by ical information consent requirement is a significant the ultra-liberal for screening jobchange not only to the historic seekers, and for “the medical privacy issue has American Civil doctor–patient relationship”, he said, Liberties Union, personal vendetlong remained unresolved, “but also an impediment to physitas. Companies and is gingerly approached by which termed the cians’ efforts to provide the best that offer to wise politicians in this year of Bush plan a medical care”. “rollback in prodredge up perCongressional elections” Citing an example not unfamiliar tection”, adding sonal information to some of the denizens of Capitol that “the touchfor modest fees Hill, Harding noted that “celebrities stone of medical records privacy is have become a fixture on the who seek help from a substance patient consent”. Internet. abuse centre and pay in cash to be Strong support for the Bush proOpponents contend that the Bush anonymous should be allowed to do posal—though with urgings towards proposal, scheduled to take effect in so without their health information even greater access to patients’ April, 2003, is a giveaway to medical being released. Similarly, Medicare records—was expressed by the marketing companies, and generally patients who elect personally to pay Washington-based medical school lowers the barriers to misuse of perfor treatment should not be at risk lobby, the Association of American sonal health information. The presifrom the prying eyes of government.” Medical Colleges (AAMC), which dent’s team insists that their scheme For several reasons, including pophas otherwise frequently clashed with simplifies proposed regulations inherular fears that bootlegged medical the White House on financial matters ited from the Clinton administration, information can adversely affect and restrictions on research involving and would speed access to health care employment prospects, the medical stem cells, plus other biomedical without risk to privacy. The Clinton privacy issue has long remained unrepolicy issues. Announcing its “strong plan required physicians to obtain solved, and is gingerly approached by endorsement”, the AAMC said the their patients’ explicit consent before wise politicians in this year of President’s proposal “moves substanrevealing anything about them to anyCongressional elections. Privacy protially toward restoration of the one, including other medical personvokes public concern more than any necessary balance between medical nel, pharmacists, and insurers. other issue, Senator Christopher privacy and other equally important Officials of the Bush administration Dodd said at Kennedy’s hearing. public interests, including quality argue that the consent requirement is The fate of this latest attempt to health care and research-related needlessly cumbersome, and would fulfil the 1996 mandate for medicaladvances in treatment and prevenentail delays for repeated consent signprivacy rules remains uncertain. tion”. Representing nearly 5000 ings as a patient moves through the hospitals, the American Hospital medical system. When a patient Association came out solidly for arrives for care, Bush would utilise a Daniel S Greenberg AP
E
THE LANCET • Vol 359 • May 4, 2002 • www.thelancet.com
1585
For personal use. Only reproduce with permission from The Lancet publishing Group.