Author Topic: S/O Gross/unethical pictures  (Read 4344 times)

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Rohanna

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Re: S/O Gross/unethical pictures
« Reply #30 on: August 21, 2010, 08:20:43 PM »
This is where we are missing each other. The "covered entity" refers to the practisioner/institution, not the patient- it's the person/institition "covered by HIPAA". HIPAA specificially says that there is no restriction on non-identifying information under it's act, so I am not sure why people are saying that consent needs to be obtained under it. Consent may need to be obtained under the employees OWN institutions rules, but that would depend on where they work, and isn't something we can debate properly here- not knowing them.

I don't know that I can agree to it being "completely unethical" unless I knew what the photo *was*.  It's rather like the grey area between taking a beach photo that happens to have a child in a swimsuit in it, versus sitting on the beach specifically taking pictures of other peoples kids bathing. I don't know where I stand on that fence until I know the exact details.

Taking pictures of Granny's bedsores would bother me more- because it's still a part of a living human, part of her skin- and we tend to keep our covered bits "private"...
« Last Edit: August 21, 2010, 08:25:28 PM by Shu »
My friends, love is better than anger. Hope is better than fear. Optimism is better than despair. So let us be loving, hopeful and optimistic. And we’ll change the world. ~ Jack Layton.

Rohanna

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Re: S/O Gross/unethical pictures
« Reply #31 on: August 21, 2010, 08:32:15 PM »
Here's an interesting article on the topic- bringing in the idea of disaster victim photos on the news, and how they could be considered unethically violating the spirit of this idea

http://academicobgyn.com/2010/02/04/hipaa-medical-case-reports-and-unbalanced-benefit-in-news-reporting/

In the article they list what HIPAA considers to be identifying info

HIPAA specifies 18 elements that cannot be published without express patient consent:

1. Names;

2. All geographical subdivisions smaller than a State, including street address, city, county, precinct, zip code, and their equivalent geocodes, except for the initial three digits of a zip code, if according to the current publicly available data from the Bureau of the Census: (1) The geographic unit formed by combining all zip codes with the same three initial digits contains more than 20,000 people; and (2) The initial three digits of a zip code for all such geographic units containing 20,000 or fewer people is changed to 000.

3. All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death; and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older;

4. Phone numbers;

5. Fax numbers;

6. Electronic mail addresses;

7. Social Security numbers;

8. Medical record numbers;

9. Health plan beneficiary numbers;

10. Account numbers;

11. Certificate/license numbers;

12. Vehicle identifiers and serial numbers, including license plate numbers;

13. Device identifiers and serial numbers;

14. Web Universal Resource Locators (URLs);

15. Internet Protocol (IP) address numbers;

16. Biometric identifiers, including finger and voice prints;

17. Full face photographic images and any comparable images; and

Any other unique identifying number, characteristic, or code (note this does not mean the unique code assigned by the investigator to code the data)

And a comment from the author "As such, the publication of a de-identified medical image along with general comments about the case, whether on the internet or in print, is a HIPAA compliant activity, and therefore should be kosher."


I like that he stated he is taking down any photos that the patient could identify as themselves, even if other could not. I think that's a fair standard to hold to- as if even the patient could not ID the photo- it is as anonymous as anything in the life can be.
My friends, love is better than anger. Hope is better than fear. Optimism is better than despair. So let us be loving, hopeful and optimistic. And we’ll change the world. ~ Jack Layton.

M-theory

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Re: S/O Gross/unethical pictures
« Reply #32 on: August 21, 2010, 08:33:44 PM »
We're going to have to agree to disagree as I have too little free time from my job processing medical records for me to want to debate this during time off. I think if you re-read not only HIPAA, but AHIMA's disambiguation of the legalese, you'll find that I'm correct.

As to ethics, there really is no grey area, at least not per my medical law and ethics training. It's misuse of photographs intended to be part of the private medical record/facilitate patient care. I was afraid that she was going around with a camera snapping pictures to post to FB, which would be a lot worse, but this is still very bad.

Rohanna

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Re: S/O Gross/unethical pictures
« Reply #33 on: August 21, 2010, 08:38:56 PM »
You are  not the only poster here with a medical background or ethics training, but I cannot debate your lack of free time :)

I have re-read this very carefully, so please don't imply that I haven't- and I have posted many sources saying that they don't believe anonymous, unidentifiable photos to be unethical- so it is obviously a grey area to many people, not just myself.

 You don't have to "like" something, or want it to happen to you, for it to be illegal or immoral. I was not happy to see myself on the front of the local paper once, as I hate how I look in pictures- but it was perfectly moral and legal for the paper to snap my picture as part of the crowd in the park.
My friends, love is better than anger. Hope is better than fear. Optimism is better than despair. So let us be loving, hopeful and optimistic. And we’ll change the world. ~ Jack Layton.

M-theory

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Re: S/O Gross/unethical pictures
« Reply #34 on: August 21, 2010, 08:42:56 PM »
You are  not the only poster here with a medical background or ethics training, but I cannot debate your lack of free time :)

I have re-read this very carefully, so please don't imply that I haven't- and I have posted many sources saying that they don't believe anonymous, unidentifiable photos to be unethical- so it is obviously a grey area to many people, not just myself.

 You don't have to "like" something, or want it to happen to you, for it to be illegal or immoral. I was not happy to see myself on the front of the local paper once, as I hate how I look in pictures- but it was perfectly moral and legal for the paper to snap my picture as part of the crowd in the park.

Sorry, I didn't intend that as "I have more medical training than you!" I intended it as "I don't want to think about this during my free time since I'll have to do it for real in a few hours." I know that I'm right, but I'm unwilling to go digging through the HIPAA Web site myself, so you can be right. :)

O'Dell

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Re: S/O Gross/unethical pictures
« Reply #35 on: August 21, 2010, 08:44:23 PM »

I agree the HC worker in the OP may very well be violating her workplace rules, but HIPPA applies to "identifying patient information"... so it would depend on what the photo was to determine that. Should she be more careful? Yes. Did she violate HIPPA...possibly not. Could she get fired? Maybe. Her bosses may decide to act on a mis-understanding of the law, as in this case


I think the HC worker is being careless posting this to FB, and it may very well cost her a job- but I wouldn't say she is being immoral. Just gross.



So she possibly did violate HIPAA since it's not clear? Then let her employer sort it out. If it's legal and ethical, then there will be no repercussions.

And I think she is being unethical. Current ethics are so weighted in favor of patient privacy that it shows bad judgment and questionable ethics on her part. Part of the reasoning behind HIPAA is wanting patients to feel secure in sharing their medical issues and concerns with medical professions without worries that their information will get around. Whether she violated the letter of the law or not, she violated the spirit of it and that is what is important. How many of her friends that saw the post and how many people here on this board are now questioning the privacy and security of their own medical records? If anyone is, then it's an indication that a line was crossed.
« Last Edit: August 21, 2010, 08:50:01 PM by Sway »
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Rohanna

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Re: S/O Gross/unethical pictures
« Reply #36 on: August 21, 2010, 08:47:21 PM »
I meant, that as we do not know what the photo was of and what was in it we can only say "maybe". I can't say "of course she didn't" as I have not seen the post. I didn't not mean "it's unclear whether she violated the rules because it could be taken either way looking at this photo". I mean, maybe the photo is of something that clearly does breach the rules- I have no idea, so I had to say "maybe".

My friends, love is better than anger. Hope is better than fear. Optimism is better than despair. So let us be loving, hopeful and optimistic. And we’ll change the world. ~ Jack Layton.

Garden Goblin

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Re: S/O Gross/unethical pictures
« Reply #37 on: August 21, 2010, 08:57:10 PM »
The simple fact that there is even debate as to whether or not it is covered by HIPAA is reason enough that posting it was unethical and rude.