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Confidentiality: Ethical and Legal Issues

Confidentiality. RulesExceptionsHealth Insurance Portability and Accountability Act (HIPAA)HIPAA law was passed to promote standardization and efficiency in the health care industry and to give patients more rights and control over their health information.. Protecting Children, the Elderly,

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Confidentiality: Ethical and Legal Issues

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    1. Confidentiality: Ethical and Legal Issues CDS 208 Chapter 6

    2. Confidentiality Rules Exceptions Health Insurance Portability and Accountability Act (HIPAA) HIPAA law was passed to promote standardization and efficiency in the health care industry and to give patients more rights and control over their health information.

    3. Protecting Children, the Elderly, & Dependent Adults from Harm Privileged communication does not apply in cases of child abuse and neglect, nor does it apply in cases of elder and dependent adult abuse. In 2003, more than 550,000 elderly people were reported abused or neglected in the U.S., but the actual number may be 4 or 5 times higher than this. Mandatory reporting laws require us in WA state to report cases of abuse/neglect of children and elderly

    4. Confidentiality & HIV/AIDS-Related Issues People that have tested HIV-positive are often very anxious, are struggling with the stigma attached to AIDS, and they typically have a great deal of anger. Those at risk are often angry at health professionals as well.

    5. Duty to Protect versus Confidentiality The HIV-positive duty to warn decision is one of the more controversial and emotional issues practitioners might encounter. State laws differ regarding HIV and the limits of confidentiality, and the law is often different for medical professionals than for licensed psychotherapists.

    6. Duty to Protect versus Confidentiality continued Two-thirds of the states have enacted legislation specifying limits to confidentiality regarding an individual's HIV status. Very few states (just Montana and Texas) offer legal protection against liability for practitioners who break client confidentiality to warn third parties at risk.

    7. Ethical & Legal Considerations in AIDS-Related Cases Courts have not applied the duty to warn to cases involving HIV infection, and therapists’ legal responsibility in protecting sexual partners of HIV-positive clients remains unclear. The ACA (2005) ethics code states that counselors “may be justified” in disclosing information to a third party who is at risk, yet counselors are not necessarily “obligated” to take this course of action.

    8. Do Tarasoff Principles Apply in AIDS-Related Psychotherapy? McGuire & colleagues (1995) suggest that therapists should be extremely cautious regarding breaching confidentiality and should first consider less intrusive measures. Therapists should be aware that some state laws prohibit warning identifiable third parties of partners who are HIV-positive.

    9. Do Tarasoff Principles Apply in AIDS-Related Psychotherapy? If an HIV-infected individual is engaging in high-risk behavior with an identifiable, unsuspecting partner, then it appears that the three criteria under the Tarasoff decision may be met.

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