Patient Confidentiality, Informed Consent, and Mandatory Reporting
What the exam tests
This domain tests the balance between protecting patient information and disclosing it when law requires. Expect questions on consent for minors, record release, abuse reporting, and reporting impaired or unsafe practitioners.
Core rules
- Patient information is confidential. Disclose it only with valid authorization, for treatment/payment/operations as permitted, or when required by law or legal process.
- Informed consent is an ongoing process. For minors, obtain consent from a parent or legal guardian as required; mature-minor exceptions vary and should be checked against Kentucky law.
- Kentucky law requires reporting suspected child abuse or neglect and adult abuse/neglect in specified circumstances. The clinician reports reasonable suspicion-not proven fact-to the designated authority and documents the report.
- Some public-health conditions and practitioner impairment may also trigger reporting duties. Follow the specific statute or board rule rather than relying on memory.
Worked example
A child presents with a corneal injury and a history that does not match the physical findings. The optometrist treats the eye, documents the inconsistent history and findings, and reports reasonable suspicion of abuse to the appropriate Kentucky authority. She does not need to investigate or confront the family, but she must document the report and continue necessary eye care.
Traps
Failing to report because “someone else will” is a violation. Over-reporting without reasonable suspicion can harm families and create liability. Releasing records to a parent or school without confirming authority is another common error.
Key points
- Confidentiality yields only to authorization or legal requirement.
- Obtain appropriate consent, including for minors.
- Report reasonable suspicion of abuse to the designated authority.
- Document reports and continue necessary care.
- Know the specific Kentucky reporting triggers rather than guessing.