Protecting Medical Record Confientiality: the Right to Know Versus

Abstract

Medical information is a sensitive issue, and its confidentiality is a matter of concern to any person. Military officers face mental health problems, emanating from occurrences in their line of duty. They need to seek the services of a mental health counselor, on condition that the secret information they give out will remain confidential. They do not do so because their information does not remain a secret as per their expectations. There is the need to have a look at the military rules that weaken the confidentiality of the information given by the soldiers. A person’s medical information needs protection from access by unauthorized parties. Medical information is sensitive, especially to the patients and those related to them. There is the need to ensure that the information that the patients provide remain sealed at all times (National Research Council, 1997). It is for this reason that the Health Insurance Portability and Accountability Act came to force, to ensure that the patients’ medical data remains confidential. Through the Act, there are limits for the use and release of any information regarding patients. It covers most of the health plans that the patients use, as well as the health care providers. With the Act in force, the patients rest assured that their information is confidential and free from unauthorized access. The only time that the health care givers can disclose the information is when the concerned patients allow them to do so. The rule requires the covered entities to reduce the uses of the information, to the level necessary for the accomplishment of the goal (Roach & American Health Information Management Association, 2006). In addition to that, the covered entities should ensure that measures are in place to keep the information a secret. The implication is that there are extents that they cannot release the medical information, and the patient retains the right to sue them for the breach of confidentiality requirement. If the health care providers engage the services of the business associates, there need to be an agreement between the parties. As such, the business associates must maintain the secrecy of the medical information at all times. The covered entities in the Act should have the procedures to follow, in determining the parties that can access the information. In the case of information leakage for whatever reason, the patient retains the right to learn about it. Privacy and strict confidentiality are major elements that define the military profession. The information related to the army officers remains in their safe, and it is not easy for the public or any other third party to gain access to it. The right to know is crucial for any person interested in the information (In Floridi, 2007). However, this is not the case with the military. The right to know is not a guarantee. The level of confidentiality between psychotherapists and their clients is very high in the army camp. As such, the customers tend to believe that the rules are porous. They make the military officers suspect the therapists, and that leads to inefficiency in service delivery. In most cases, the officers are reluctant to professional care from the therapists. They argue that taking any chances to disclose the information would mean that they face prosecution for the information they provide. The members of the military fraternity have the right to receive confidentiality of the medical information they give to anyone (In Floridi, 2007). It is their expectation that all will be well, and they attend the therapies to get the assistance they direly need. However, contrary to the expectations of many, the rules that govern the military create no room for confidentiality of the information. For instance, the communications regarding the mental health do not have the necessary safeguard against any chances of the breach of secrecy. As such, the rules require that the therapist must report the client, if he or she appears to be a threat to anyone. It is for this reason that a sour relationship is likely to occur between them and the military clients. Experts who have been offering psychological services to the patients maintain that in the army, confidentiality is a term that holds little meaning. A military therapist has a legal duty to report the character of the patient, without the consent from the patient (In Floridi, 2007). This move is contrary to the Health Insurance Portability and Accountability Act. It provides that should the medical practitioner need to disclose any information regarding the patient, she or she should consent to the intended disclosure. Much of this information is a secret of the beholder. Revealing it to the therapist means that the client has the confidence in the professional, that the information will remain a secret for both of them only. In the case where the officer faced psychological disorder due to things that happened to him, or those that he committed, there is the need for the therapist to retain the secrecy of the information. If the situation does not receive the necessary attention, then, the officers will keep the secrets however disturbing they might be. They are likely to commit a suicidal crime, such as mass shooting and other fatal cases. They, therefore, need a person who can offer them mental health services, and retain the information they receive from the officers. The most affected group of soldiers are the perpetrators of war crimes. They are aware that chances of them getting prosecution are high, regardless of the fact that they need the counseling sessions. These officers should first look for behavioral health treatment (In Floridi, 2007). They need to do so before seeking the psychotherapy services, which may disclose them if they behave suspiciously. According to the military rules, the officers seeking the services need to sign an agreement that the information may be disclosed without their consent. This rule explains the reason why the officers need to look for the behavioral treatment first; so that they get to avoid the disclosure scenarios that may be costly to them. The defense department directives give a duty to the psychotherapists to report the war crimes possibly committed by the officers. However, it is not necessary for them to do so. Some scenarios exist that warrant the unconsented disclosure of the information. For example, the therapist may disclose the medical information if the state or federal law, or the service regulations, has it that the disclosure is necessary (Siljander & Juusola, 2012). In such a case, the therapist has no option but to disclose the information to the authorities. In such a case, he or she would not have breached the confidentiality agreement, and hence not bound by the Act. In addition to that, if it happens that the disclosure leads to the safety of the military fraternity, then the therapist has a duty to disclose. For example, in the process of counseling, the therapist may note that the officer is not in a good state of mind; and he or she may put the lives of the colleagues in danger. The best approach is to report the situation, and then continue assisting the officer to come back to a sober state of mental health. More to that, the disclosure may be to the good of the entire team, for the accomplishment of the military mission. The disclosed information is useful if it assists the officers to meet the goal at hand. The military chaplains are the best fit for the therapy, and the soldiers may seek their assistance. The priests enjoy stronger privileges on the rules of communication (Siljander & Juusola, 2012). Chances of them disclosing the information that the soldiers provide are slim. As such, the affected soldiers may opt to go the chaplain way of counseling, given the religious heart they possess. For a long time, the commanding officers and military prosecutors could access the confidential information from the therapy clients, and review it without the consent of the patient. It took the ruling of the Supreme Court, which required that the federal courts should not force the psychotherapists to disclose any information from the patients without their consents. According to the ruling, the mental health records of the service men and women were not to be used as a source of evidence in any judicial proceeding involving the officers. Due to the questionable confidentiality, the members of the disciplined forces still raise their concerns; that their therapy professionals may make known the information regarding their activities (Siljander & Juusola, 2012). Apart from the major war crimes, the officers express their fear that even minor occurrences may come to light through the therapists. It is for this reason that the troops avoid any counseling session, on the ground that the information they give out may be a source of troubles in their career. They further fear that through the disclosures, they may never again get the chance to take part in the combat operations. The officers face numerous challenges in the line of duty (Siljander & Juusola, 2012). Some of them live in anguish and mental problems, because of the issues that surround their past operations. Other officers took part in deadly combat missions, which led to the loss of many lives under their watch. It is for this reason that the officers find themselves in trauma, and the only way out of it is to seek mental health counseling. They cannot avoid disclosing much of the deep secrets they possess, for an effective counseling session. However, the lack of confidentiality makes them vague in their words. They cannot give some details, some of which need to be spoken out for effective healing of their conscience. In the end, such officers remain in anguish and mental disorders, and they can even end up committing suicide. For this reason, there is the need for the military personnel leaders to have a look at the existing rules. They need to move an extra mile and adopt the Supreme Court ruling. This way, they will create a conducive environment for the soldiers to seek the necessary help; and avoid chances of them committing more serious crimes in the future. The ability to air their issues to the counselors is a sure way to assure them of the mental healing. As such, they need to speak to someone who can keep their secrets; in that way, more of the officers will be willing to seek the counseling services and keep in touch with the activities in their line of duty.

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