Ethical Considerations of Privacy and Cyber-Medical data

Monster In Law Soundtrack Download - Ethical Considerations of Privacy and Cyber-Medical data

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In 1818, British author Mary Shelley's tale of Dr. Frankenstein's infamous creation startled and captivated a receptive audience. Just as the macabre, but resourceful, physician created life from non-life that terrorized the local countryside, we have created a "cyberspace monster" that "lives" and knows no boundaries. It may not of course terrorize us, but we are likewise captivated by it. It profoundly influences and impacts our everyday activities, but it is also out of control and has spawned many controversial issues engaging free speech, censorship, intellectual property, and privacy. The free shop and community norm may, in some measure, be capable of regulating these issues and at last help allay many of our concerns. A major and controversial concern that requires supplementary conference is safeguarding the confidentiality of secret medical information.

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Expectations of Privacy and secret medical Information

According to attorney and privacy law specialist, Ronald B. Standler, "Privacy is the hope that confidential personal data disclosed in a secret place will not be disclosed to third parties, when that disclosure would cause either embarrassment or emotional distress to a someone of inexpensive sensitivities" (Standler, 1997). Someone else theorist, Ruth Gavison, defines privacy as "the limitation of others' entrance to an individual with three key elements: secrecy, anonymity, and solitude." Secrecy or confidentiality deals with the limits of sharing knowledge of oneself. Anonymity deals with unwanted attentiveness solitude refers to being apart from others (Spinello, 2003). Basically, we want to protect the integrity of who we are, what we do, and where we do it. Regardless of our definition, the right of privacy usually concerns individuals who are in a place reasonably foreseen, to be private. data that is group record, or voluntarily disclosed in a group place, is not protected.

The open architecture of the modern phenomenon that we call the Internet raises very unique ethical concerns about privacy. data is sent effortlessly over this vast global network without boundaries. Personal data may pass straight through many distinct servers on the way to a final destination. There are virtually no online activities or services that guarantee absolute privacy. It is quite easy to be lulled into reasoning your activity is secret when of course many of these computer systems can capture and store this personal data and of course monitor your online activity (Privacy proprietary Clearinghouse, 2006). The Net's fundamental architecture is designed to share data and not to conceal or protect it. Even though it is possible to invent an sufficient level of security, with an thorough risk level, it is at immense cost and requisite time.

Medical records are among the most personal forms of data about an individual and may consist of medical history, lifestyle details (such as smoking or participation in high-risk sports), test results, medications, allergies, operations and procedures, genetic testing, and participation in explore projects.The security of this secret medical data falls under the area of medical ethics. The realm of medical ethics is to analyze and resolve ethical dilemmas that arise in medical convention and biomedical research. medical ethics is guided by correct ideas or standards that address: Autonomy, Beneficence, Nonmaleficence, Fidelity, and Justice (Spinello, 2003). The principle of Autonomy includes a person's right to be fully informed of all pertinent data linked to his/her healthcare. A conference of medical ethical ideas and sick person proprietary leads us to supplementary discuss legislation designed to enounce and protect these cherished rights.

Access to secret medical data and the health guarnatee Portability and accountability Act of 1996

Since 400 B.C. And the creation of the Hippocratic Oath, protecting the privacy of sick person medical data has been an leading part of the physician' code of conduct. Unfortunately, many organizations and individuals not subject to this correct code of conduct are increasingly requesting this secret information.Every time a sick person sees a doctor, is admitted to a hospital, goes to a pharmacist, or sends a claim to a healthcare plan, a record is made of their confidential health information. In the past, all healthcare providers protected the confidentiality of medical records by locking them away in file cabinets and refusing to impart them to anyone else. Today, we rely on "protected" electronic records and a complicated series of laws to enounce our confidential and secret medical records.

Congress duly recognized the need for national sick person record privacy standards in 1996 when they enacted the health guarnatee Portability and accountability Act Hipaa). This act was effective April 14, 2003 (small health plans implementation date was April 14, 2004) and was meant to improve the efficiency and effectiveness of the nation's healthcare system. For the first time, federal law established standards for sick person medical record entrance and privacy in all 50 states. The act includes provisions designed to save money for health care businesses by encouraging electronic transactions, but it also required new safeguards to protect the security and confidentiality of that data (Diversified Radiology of Colorado, 2002).

There are three requisite parts to Hipaa: Privacy, Code Sets, and Security. The security section is supplementary subdivided into four parts: administrative Procedures, physical Safeguards, Technical security Services (covering "data at rest"), and Technical security Mechanisms (covering "data in transmission").

Privacy:

The intent of the Hipaa regulations is to protect patients' privacy and allow patients greater entrance to their medical records. The Act specifically addresses patients' Protected health data (Phi) and provides patients with greater entrance to and modification of their medical records. Prior to providing sick person services, the Covered Entity must first receive the patient's consent to share Phi with such organizations as the guarnatee billing company, the billing office, and physicians to which the sick person may be referred. Individuals must be able to entrance their records, request revision of errors, and they must be informed of how their personal data will be used. Individuals are also entitled to file formal privacy-related complaints to the branch of health and Human Services (Hhs) Office for Civil Rights.

Code Sets:

Under Hipaa, codes are standardized to improve security and security of health information. Agreeing to these new standards, a code set is any set of codes used for encoding data elements, such as tables of terms, medical pathology codes, course codes, etc.

Security:

The security section is divided into four major parts:

1. Administrative, which requires documented formal practices, the operation of security measures to protect data, policies and procedures regulating conduct of personnel in protecting data, security training, incident procedures, and termination policies.

2. physical Safeguards impart to the security of physical computer systems, network safeguards, environmental hazards, and physical intrusion. One must reconsider computer screen placement, pass code protection, and computer locks to control entrance to medical information.

3. Technical security Services refers to Phi stored on the computer network and how it is securely stored and accessed. Those using the Phi must be logged on and authenticated. An audit trail of authenticated entrance will be maintained for 6 years.

4. Technical security Mechanisms refers to Phi transmitted over a transportation network such as the Internet, frame relay, Vpn, secret line, or other network. Phi transmitted over a transportation network must be encrypted.

There are also some noticeable shortcomings to Hipaa. The act did puny to of course make health guarnatee more "portable" when an employee changes employers. Also, the Act did not significantly increase the health insurers' accountability for wrongdoing with provisions that are often difficult to monitor and enforce. There is also much obscuring for patients, as well as healthcare providers, in regard to the interpretation of the act (Diversified Radiology of Colorado, 2002).

Other Laws, Regulations, and Decisions about secret medical Information

Besides Hipaa, there are leading state regulations and laws, and federal laws and legal decisions, about the privacy and confidentiality of medical data (Clifford, 1999):

The Privacy Act of 1974 limits governmental agencies from sharing medical data from one branch to another. Congress declared hat "the privacy of an individual is directly affected by the collection, maintenance, use and dissemination of personal data ...," and that "the right to privacy is a personal and fundamental right protected by the Constitution of the United States ..." (Parmet, 2002).

The Alcohol and Drug Abuse Act, passed in 1988, establishes confidentiality for records of patients treated for alcohol or drug abuse (only if they are treated in institutions that receive federal funding).

The Americans with Disabilities Act, passed in 1990, prohibits employers from production employment-related decisions based on a real or perceived disability, including reasoning disabilities. Employers may still have entrance to identifiable health data about employees for inexpensive business needs including determining inexpensive accommodations for disabled workers and for addressing workers payment claims.

Supreme Court decision in Jaffee v. Redmond: On June 13, 1996, the Court ruled that there is a broad federal privilege protecting the confidentiality of transportation between psychotherapists and their clients. The ruling applies to psychiatrists, psychologists and group workers.

Freedom and Privacy restoration Act of 1999: Designed to prohibit the creation of government unique medical Id numbers.

Managed Care and Cyber Threats to secret medical Information

The introduction of the Internet and the advances in telecommunications technology over the last two decades allows us to entrance vast amounts of medical information, regardless of time, distance, or remoteness, with relative ease. This cyber entrance to medical data has profoundly changed how healthcare providers treat patients and offer advice. No longer are there barriers to the effective replacement of health data and requisite life-saving medical information. In addition to the many benefits of cyber entrance to medical information, there are also serious threats to our personal privacy and our medical information.

The intense interest for the security and privacy of medical data is driven by two major developments. The first is the increase of electronic medical record keeping that has supplanted paper records. A record from the National Academy of Sciences states that the healthcare industry spent between and billion on data technology in 1996 (Mehlman, 1999). This was the year that the health guarnatee Portability and accountability Act was passed with most of the expenditure attributed to converting hard-copy data to electronic formats.Electronic medical records (Emrs) present a requisite threat to maintaining the privacy of patient-identifiable medical information. This medical data can be retrieved instantaneously by anyone with entrance and passwords. Although hard-copy medical data can be of course copied, electronic records are much more of course copied and transmitted without boundaries.

The second major improvement that concerns the privacy of sick person data is the farranging increase of managed care organizations. There is a interrogate for an unprecedented depth and breath of personal medical data by an addition amount of players. In contrast to traditional fee-for-service healthcare, the supplier of care and the insurer can be the same entity. In this situation, any medical data in the proprietary of the supplier is also known to the insurer. This is common in all forms of managed care, but most clear in closed-panel Hmos. This sharing of data increases the fear that the insurer may use the data to limit benefits or terminate guarnatee coverage (Mehlman, 1999).

Some managed care clubs are reporting secret medical data to an extreme in requiring providers to record to case managers within twenty-four hours any case that is determined a high risk possible for the client, a second party, the employer, or the managed care company. Examples consist of such things as possible danger to self or others, suspected child abuse, possible threats to national security or the client organization, client's request for records, complaint about employee assistance program services or threat of a lawsuit, and possible involvement in litigation including confession or knowledge of criminal activity. No mention is made about client privacy or proprietary about the publish of this information. Nothing is also said about what will be done with the data that is shared (Clifford, 1999).

Another issue with managed care clubs is the large volume of data processed and the carelessness in handling medical information. A salient example deals with lost records as noted in a 1993 observe sample of San Francisco Bay Area psychologists. In this survey, 59% of reports were mailed or faxed to wrong persons, charts accidentally switched, or permissible authorization not obtained (Clifford, 1999).

Maintaining and Protecting Electronic secret medical Information

In order to enounce and protect valued secret medical information, we must all the time be vigilant and proactive. Basic steps can be taken prior to using electronic data sharing. For example, when signing a "Release of Information" form, read everything carefully. If not clearly understood, ask questions. Also, remember that Hipaa grants you the right to request that your healthcare supplier restrict the use or disclosure of your medical information. Make sure those who ask for data are properly identified and authorized to collect this information. Finally, make sure that the someone collecting data uses at least two "identifiers" to ensure permissible identification of sick person (e.g. Name, last four of group security number, address, telephone, number, birth date etc.

When dealing with electronic and computerized medical information, the situation gets more tenuous and much more complex. collect networks and websites, passwords, firewalls, and anti-virus software, are of course the first steps in a plan of protection. Passwords must be complex, using numbers, letters, and cases, yet also of course remembered. To enounce security, experts propose that passwords be changed every 90 days or if they are believed to be compromised. In addition, any secret medical data sent on the Net or non-secure networks should be encrypted. Encryption (64 or 128 bit) is translating data into a secret code where a key or password is required to read the information.

Further security is in case,granted by using privacy enhancing P3P frameworks, filtering software (e.g. Mimesweeper), message authentication codes "(Macs), and "digital signatures." The Platform for Privacy Preferences task (P3P) is a technological framework that uses a set of user-defined standards to negotiate with websites about how that user's data will be used and disseminated to third parties (Spinello, 2003). This P3P architecture helps define and improve cyberethics, improves accessibility, improves consistency, and increases the farranging trust in using cyberspace. Macs use a common key that generates and verifies a message whereas digital signatures ordinarily use two complementary algorithms - one for signing and the other for verification.

There has also some creative technology proposed for maintaining and protecting secret medical information. In October 2004, the "VeriChip" was beloved by the Fda for implantation into the triceps of patients. The chip is about the size of a grain of rice and is inserted under the skin during a 20-minute procedure. This imperceptible chip shop a code that can scanned to supplementary publish a patient's secret medical information. This code is then used to download encrypted medical information. The course cost is about 0-200 (Msnbc, 2004).

Another more ordinarily used medical data tool is the "smart card," a reputation card sized gadget with a small-embedded computer chip. This "computer in a card" can be programmed to achieve tasks and store leading information. during an emergency, paramedics and accident rooms qualified with smart card readers can rapidly entrance potentially life-saving data about a patient, such as allergies to medication, and persisting medical conditions. There are distinct types of smart cards: memory cards, processor cards, electronic purse cards, security cards, and JavaCards. These cards are tamper-resistant, can be Pin protected or read-write protected, can be encrypted, and can be of course updated. These unique features make smart cards advantageous for storing personal medical data and are beloved throughout the world. In Germany and Austria, 80 million habitancy have the capability of using these smart cards when they visit their physician (Cagliostro, 1999).

There is also a up-to-date proposed government plan to create a national ideas of electronic health records (Ehrs). Details consist of the construction of a National health data Network that will electronically associate all patients' medical records to providers, insures, pharmacies, labs, and claim processors. The sharing of vital data could improve sick person care, consist of more correct and timely substantiation of claims, and be an asset to group health in emergencies. The goal is to have it operational by 2009. Even with laudatory goals of rescue money, production medical care more efficient, and decreasing drug reactions and interactions, there are still possible dangers to this national plan. There are valid concerns that pharmaceutical clubs may attempt to shop a new drug or gadget for your exact medical condition. There are also strong worries of exploitation and abuse of personal data. Who will monitor entrance to the information? There are also concerns that lenders or employers may rely on secret medical data to make business decisions. Then there is all the time the ever present fear of hackers and pranksters retrieving your personal information. There are still so many questions unanswered (Consumer Reports.org, 2006).

In conclusion, we are now stuck with a "Cyberspace Monster" and all of its advantages and shortcomings. When we use cyberspace, we can have no expectations of privacy and we must accept a level of risk. Therefore, when transmitting and sharing secret medical information, we must be all the time aware to take precautions in safeguarding our privacy as much as possible by using collect networks, P3P architecture, passwords, firewalls, encryption, message codes, digital signatures, and devices like smart cards and "VeriChips." medical records are among the most personal forms of data about an individual, but we are challenged to find a balance between society's interest in protecting medical confidentiality and the legitimate need for timely entrance to requisite medical data especially with fears of influenza pandemics and bioterrorism. When this data is transferred into electronic format, we have heightened concerns about maintaining and protecting this secret data. With managed care, there is a interrogate for an unprecedented depth and breath of personal medical data by an addition amount of players. While the Hipaa provisions are a welcomed start in protecting our secret medical information, we must remain vigilant of the ever addition need to protect this extra information.

References:

Cagliostro, C. (1999) Smart card primer.

Clifford, R. (1999) Confidentiality of records and managed care legal and ethical issues.

Consumer Reports.org (2006). The new threat to your medical privacy.

Diversified Radiology of Colorado (2002) History: Hipaa general information.

Mehlman, M. J. (1999) Emerging issues: the privacy of medical records.

Msnbc (2004) Fda approves computer chip for humans.

Parmet, W. E. (2002) group health security and privacy of medical records.

Privacy proprietary Clearinghouse (2006) Internet privacy resources.

Spinello, R. A. (2003) CyberEthics: Morality and law in cyberspace. Jones and Bartlett Publishers, Sudbury, Ma

Standler, R. B. (1997) Privacy law in the Usa.

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