Disclosure in a Disaster Situation: Protecting Patient Privacy Rights with Public Safety
First and foremost it should be noted that the protection of a patient’s privacy is a right held by all patients regardless of ethnicity, religion, or other. It is a right which is to be respected in all situations, including that of a disaster. Patients always retain the right to determine through consent what information is disclosed, to who it is disclosed to, and for what purposes.
Consent to disclose information should be sought as early as possible either in writing or orally. This does not change in the event of a disaster but may prove more difficult. If consent is not provided the professional judgement of health care providers is to be used when disclosing information. Typically, in a disaster situation information on the patient’s whereabouts and current condition is shared at the first available opportunity to family members or friends involved in the care of the patient.
Despite the right of a patient to retain privacy and keep some information free from disclosure, the right to refuse disclosure is not always granted. A disaster situation may provide good reason for increased sharing of medical information.
If consent to disclose is provided, or if it is being done in the best interests of the patient, it is typically done only when a request for information is done under the condition that the name of the patient is given first. The patient has been referred to by name.
All of the above can be superseded if through disclosure of information the safety of public health is put into further jeopardy i.e. through disclosure the disaster spreads perhaps through alarmist irrational behaviour. Often however, when speaking of public safety in this context, it is an element which as a general principle is used to argue for increased information sharing so that hospitals can effectively coordinate their efforts.
In summary, basic health information can be disclosed in a disaster situation if consent is given, is in the best interests of the patient, or if there is a need for public health and safety. Information can likewise be withheld if disclosure would enhance the disaster, consent is not given, or if it is not in the best interests of the patient.