NCJ Number
17686
Journal
Columbia Law Review Volume: 73 Issue: 8 Dated: (DECEMBER 1973) Pages: 1579-1612
Date Published
1973
Length
33 pages
Annotation
AFTER A BRIEF INTRODUCTION TO THE PROBLEM OF DRUG ABUSE, THE AUTHORS DISCUSS THE NEED FOR RECORDS CONFIDENTIALITY, THREATS TO CONFIDENTIALITY, AND STATE AND FEDERAL LAWS THAT HELP MAINTAIN CONFIDENTIALITY OF TREATMENT RECORDS.
Abstract
IT IS ARGUED THAT MEDICAL TREATMENT OF DRUG ABUSE CAN BE EFFECTIVE ONLY IF PATIENTS ARE ASSURED THAT THEIR RECORDS WILL REMAIN CONFIDENTIAL. HOWEVER, IT IS NOTED THAT REHABILITATION CAN SOMETIMES BE FURTHERED IF TREATMENT CENTERS DISCLOSE INFORMATION TO EMPLOYERS OR SOCIAL SERVICE AGENCIES. DRUG TREATMENT PROGRAMS MUST THEREFORE STRIVE TO MAINTAIN CONFIDENTIALITY GENERALLY, WHILE MAINTAINING ENOUGH FLEXIBILITY TO DISCLOSE INFORMATION WHEN INDICATED. WHILE CENTERS CAN DO MUCH TO SAFEGUARD CONFIDENTIALITY THROUGH THEIR WON RECORD-KEEPING PROCEDURES, THE AUTHORS CONTEND THAT SUCH EFFORTS ARE NOT ENOUGH; RECORDS MAY BE THREATENED THROUGH POLICE HARASSMENT, COURT PROCESS, AGENCY DATA COLLECTION, AND SOCIAL-WELFARE AGENCY PRESSURE. PRESENT LEGISLATION DOES NOT GO FOR ENOUGH, ACCORDING TO THE AUTHORS. RULES OF PHYSICIAN-PATIENT PRIVILEGE PROTECT PATIENTS FROM DISCLOSURE OF MEDICAL INFORMATION IN COURT OR UNDER COURT ORDER, BUT NON-MEDICAL IDENTIFICATION RECORDS AND OUT-OFCOURT DISCLOSURE ARE NOT COVERED. CONGRESS, RECOGNIZING DRUG ABUSE TO BE A PROBLEM OF NATIONAL SCOPE, HAS TAKEN THE LEAD IN EXTENDING THE PROTECTION OF CONFIDENTIALITY. CURRENT STATUTES AND REGULATIONS, APPLYING TO MANY FEDERALLY FUNDED AND REGULATED PROGRAMS, RESTRICT BOTH IN-COURT AND OUT-OF-COURT DISCLOSURES OF BOTH MEDICAL AND IDENTIFICATION RECORDS. FEDERAL LAW ALSO PROVIDES FOR DISCLOSURE, WITH THE PATIENT'S CONSENT, TO AID REHABILITATION. THE AUTHORS FIND THAT EVEN THESE FEDERAL PROVISIONS, HOWEVER, ARE FAR FROM ADEQUATE. UNDER FEDERAL LAW, RECORDS OF MOST TREATMENT CENTERS CAN BE DISCLOSED UNDER COURT ORDER. DIRECTORS OF METHADONE AND OTHER 'RESEARCH' PROGRAMS MAY BE AUTHORIZED TO WITHHOLD RECORDS UNCONDITIONALLY, BUT THE AUTHORS FIND THAT THE LEGISLATION IS SO CONFUSED THAT EVEN THIS AUTHORIZATION MAY BE DEFIED BY SOME COURTS. THERE ARE SEVERAL OTHER WEAKNESSES NOTED IN THE FEDERAL PROVISIONS. ORAL COMMUNICATIONS, FOR EXAMPLE, ARE NOT PROTECTED AT ALL. ALSO, THE PATIENT HAS NO RIGHT TO A HEARING EITHER TO ARGUE AGAINST COURT-ORDERED DISCLOSURES OR TO SEEK A REMEDY FOR UNAUTHORIZED DISCLOSURE. FINALLY, SINCE DISCLOSURE IS SOMETIMES PERMITTED WITH THE PATIENT'S CONSENT, SOCIAL-SERVICE AGENCIES OR OTHERS MAY COERCE THIS CONSENT FROM THE PATIENT, AND THESE RECIPIENTS ARE UNDER NO DUTY TO KEEP THE DISCLOSED INFORMATION CONFIDENTIAL. THE AUTHORS CONCLUDE THAT PRESENT LAW INADEQUATELY PROTECTS THE PRIVACY OF DRUG ABUSE PATIENTS. IT IS RECOMMENDED THAT FEDERAL AND STATE GOVERNMENTS ENACT COMPREHENSIVE LEGISLATION TO INSURE CONFIDENTIALITY. (AUTHOR ABSTRACT