Patient Rights, Consent, and Confidentiality
Patient Rights, Consent, and Confidentiality
This domain tests informed consent, refusal, minors, privacy, and release of records.
Core rules
- Patients have the right to information about diagnosis, proposed interventions, risks, benefits, alternatives, and the right to refuse. Consent should be documented, not assumed.
- For minors, a parent or legal guardian generally consents. Recognize exceptions for emancipated minors and services minors may consent to under Missouri law.
- Confidentiality protects all identifiable health information. Disclose only for treatment, payment, operations, with valid authorization, or when law requires, such as abuse reporting, communicable disease reporting, or a court order.
- HIPAA sets a federal floor; Missouri law may add stricter requirements. Follow the stricter rule.
- Minimum necessary: share only what is needed. Do not discuss patients in waiting rooms, elevators, or social media.
- Patients may access their records under the applicable process. Do not refuse simply because the PT is annoyed.
Worked example
A patient’s employer calls asking whether the patient can lift 50 pounds. The PT has no authorization. Reasoning: the PT may discuss employment-related treatment only if authorized, but detailed health information requires a signed release. The PT should verify the authorization, release only the functional information needed, and document the disclosure.
Traps
A signed financial responsibility form is not a records release. A subpoena may require a response, but check the applicable law and notify the patient if allowed. Do not assume a family member has access just because they are present.