Confidential medical information should only be disclosed with individuals who need to know it in order to:

Confidential medical information should only be disclosed with individuals who need to know it in order to:

Select all that apply

A. provide background for those praying for the individual

B. properly care for patients

C. protect their own health

D. satisfy the curiosity of family or friends

E. provide legitimate clinical teaching experience

2) Medical privacy can be protected through the following strategies:

Select all that apply

A. Avoiding sharing personal or sensitive information that is not necessary or essential to the patient’s care or to informed consent

B. Discussing details of the patient’s case on social media (Facebook, Twitter, Snapchat, etc,), even if you do not name the patient.

C. Arranging for patient care or family meetings to be held in a private setting whenever practical

D. Discussing the patients case with your spouse (assuming that he or she is not a member of the care team responsible for the patient)

E. Continuing to discuss a patient’s case in a public setting, such as an elevator, cafeteria or lobby.

3) Howard, a 33-year-old, Orthodox Jewish man, was admitted to a Cleveland hospital, after a home hospice nurse found him  dehydrated and hyperthermic–the temperature inside his apartment had been 120 degrees that afternoon. Howard had been diagnosed with HIV about 8 years ago, has been symptomatic with opportunistic infections for about 2 years, and developed Kaposi sarcoma (an end-stage HIV related cancer of the skin) several months ago. The hospice admitting nurse noted:

Pt. lives alone. Family lives in Israel and does not know of illness at pt’s request; [he] feels they would be shamed, [he] has not seen family for 17 years since he left Israel.

Since he become ill, Howard formed alliances with the Cleveland AIDS Task Force and a local Jewish community. Fear of rejection and a desire to keep his diagnosis secret complicated the Orthodox community’s efforts to help him. Because Howard became “withdrawn and nervous” when confronted with end-of-life decisions, a rabbi friend was designated his Health Care Agent  in his Advance Directive in the event that Howard looses decision-making capacity.

Imagine that we are now at a point in which Howard lacks decisional capacity and is not expected to regain such. which of the following statements are true:

Select all that apply

A. Despite the patient’s clear refusal to inform his family in Israel of his terminal illness, once Howard loses decisional capacity and his rabbi friend begins to act as his Health Care Agent, it is ethically permissible for rabbi to contact Howard’s family to invite them to his dying bedside.

B. Given the patient’s desire to keep his diagnosis secret, it is ethically preferable to share the minimal information necessary for the Health Care Agent to make informed choices for Howard. For example, the rabbi might be told that Howard’s cancer is a terminal illness and that its treatment is complicated by multiple viruses.

C. Given the patient’s fear of rejection, the rabbi should not be given any information about Howard’s diagnosis, prognosis or limited treatment options, even if the rabbi is now acting as Health Care  Agent.

D. HIPAA permits disclosure of PHI (personal health information) to the pt-designated Health Care Agent for purposes of medical decision making (for example, to “consent’ to or refuse treatment on the patient’s behalf).