I have a watched a lot of TV shows on criminal investigations…
One of the common thing seems like the cops tricking the medical Doctor to release information of the suspect. So I have 3 questions :
1> I understand that the cops can lie and can withhold information from a suspect during interrogation. Are they legally allowed to do the same to the suspect’s medical care provider ? By same, I mean providing partial disclosure or knowingly withhold information to the medical provider for the sole aim of obtaining incriminating information ?
2> Is the medical provider legally required to document requests by cops and reasoning to release information ? In fact does the medical provider need to document all requests for information and the reasons to comply/deny ?
3> If a patient instructs his medical provider not to release information unless sub-poena’d, will the medical provider have to comply ?
In Canada, a suspect was presented with a signed confession by his lover (that they had murdered his wife). He basically laughed in their faces, and then when he got out had his lawyer pursue forgery charges. The Canadian Supreme Court, not at the time known for activism, ruled that the police could say or do anything like that in the pursuit of the truth so it was not technically forgery. Not sure about the USA rules, but lying, misleading, or confusing the doctor is probably fair game. What they cannot do, I am sure, is outright lie and in any way say the suspect has given permission. When they trick a doctor into revealing something, they have tricked him into breaking the law…
I have never heard of any requirement to document questions. The medical provider must keep records as part of their job, and then has a duty to keep those records confidential according to the laws. I assume if the police want to see records, they have to ask a judge for a warrant and explain what they will find, and why they believe the data is relevant and necessary. The only gocha I can think of is whether there is the requirement to keep police investigations confidential, if warning the patient would “obstruct” the investigation of an on-going crime. In fact there are certain reporting obligations anyway - child abuse, gunshot wounds, certain diseases, etc.
IANAL, but a doctor is not a lawyer. His only obligation is to the patient data confidentiality law, to keep that information private. (I don’t even recall hearing that they had to keep the fact that X is a patient confidential, other than the “I’m not giving you a list of all my patients”.) The only thing I can imagine a patient being allowed to change on that is to consent to having their records, or part of the data, released.
In the US, medical records can not be released to the police or any third party without the patient’s consent or a subpoena. To do so would be a HIPAA violation. I have had the police asking for medical records of patients suspected of selling their narcotic medication and they did try to get them without any official paperwork. Fortunately, my medical records staff are trained well and they police ended up getting a judge to sign a warrant for the information.
Whenever I have had to get medical information it was with a search warrant. The actual process for getting a search warrant is so tedious and boring it will not be on TV. Its much quicker and more exciting to fool the doctor on TV or the movies. But what’s the point of getting information if you can’t use it because it was obtained improperly?
The only time I see us skirting around HIPAA has nothing to do with an investigation. When someone gets a needle stick or is exposed to a possible blood borne pathogen we will informally ask the medical personnel if we have anything to worry about. Getting the official paperwork through takes time and its something we want to know right away.
I would think after a needle stick, you can’t ask “did that bozo have HIV?” but you can ask “do I need to do anything special to be safe?” If the doctor knows (or can check) if there is a blood-borne disease involved, they would be negligent in not giving you the necessary treatment. I imagine doctor A is entitled to ask Doctor B about patient C or look up their records, if it is a valid medical case that requires them to know. They just can’t pass on the information if they don’t have to. Of course, if they say “in two weeks we’ll do an HIV test” I thik 90% of patients can put 2+2 together.
The treatment is mandatory and started immediately. The questions are for peace of mind. But any official inquiry about the medical status of a patient must be done with a court order or consent.
Yes, I meant if the doctor tells you “start taking these pills immediately, plus these needles, and in 2 weeks we’ll do an HIV test.” Then it’s not hard to figure out what the idiot who left the needle had, no matter how private his records.
I would imagine that a doctor is required to tell you what you are at risk for. If that means you can figure out something about someone else, that’s not really a breach of confidentialty as a fact of life. Diseases are contagious in some circumstances.
Of course, a police officer isn’t going to risk a deadly disease to nail a suspect; if they did, maybe they should not be on the force. maybe the department does not need the Worker’s Compensation risk.
In the case of the needle stick, I’m fairly certain the doctor has the right to inform the police of something like HIV becasue the HIPAA laws have a provison for “matters of public health”. That is to say, if a doctors tells their patient they have TB and the patient announces they can’t afford to miss work, and so they will be back in the kitchen at Olive Garden two hours from now, the physician can take action. I would think the needle stick falls into this same category. If the cop gets HIV, HEP C, or something else that threatens their health and that of others, the physican can disclose the specific threat, without revealing the entire medical record of the patient assuming no subpeona has been issued.