Patient Rights, Informed Consent, Confidentiality, and Mandatory Reporting Obligations
This domain tests how patient autonomy and legal reporting duties interact in OT practice. Patients have rights to dignity, privacy, information, refusal, and complaint; licensees have duties to obtain consent, protect records, and report suspected abuse or neglect.
Core rules
- Patients should receive clear information about evaluation, treatment, risks, benefits, alternatives, and the right to refuse. Consent should be documented and revisited when the plan changes.
- Confidentiality is governed by professional ethics, Kentucky law, and HIPAA. Disclose only the minimum necessary information and use secure methods. Patients may authorize broader disclosure in writing.
- Kentucky law makes any person a mandatory reporter of suspected child abuse or neglect under KRS 620.030. Adult protective reporting also applies to suspected abuse, neglect, or exploitation of adults with disabilities under KRS 209.030.
- Good-faith reports are protected; the reporter should not investigate or confront the alleged abuser. Report to the designated state agency and document the report.
- HIPAA does not block a mandatory report; it permits disclosures required by law.
Worked example
A pediatric patient has unexplained burns and the caregiver gives inconsistent explanations. The OT must report the suspicion to the Cabinet for Health and Family Services and document the facts observed, not the OT's conclusion of who caused the injury.
Traps
Do not promise absolute confidentiality; do not delay a mandatory report to finish treatment; do not let a supervisor overrule a legal reporting duty.