Patient Rights and Confidentiality
Patient rights questions test your ability to protect autonomy, privacy, and access to care. Know the Patient Care Partnership themes and HIPAA basics: patients have the right to informed consent, to refuse treatment, to privacy and confidentiality, to access their records, to know caregivers' identities, and to be free from restraint and abuse.
Key concepts:
- Confidentiality is the default. Disclosure requires patient authorization, a legal mandate (reporting, court order), or a permitted treatment/payment/operations purpose.
- Minimum necessary applies to disclosures: share only what is needed.
- Privacy includes physical privacy, conversations, and electronic access. Do not discuss patients in public areas or access records of patients not in your care.
- Restraints require a provider order, the least restrictive option, ongoing monitoring, and time-limited renewal; they are never for convenience or discipline.
- Advocacy means supporting the patient's informed choices and speaking up when rights are threatened.
- Research and teaching require additional safeguards and consent.
Traps: options that disclose information to family without the patient's permission, that discuss a patient in an elevator, that access a celebrity's chart out of curiosity, or that apply restraints without an order. Another trap is assuming a patient loses rights on admission or when confused-incapacity triggers surrogate decision-making, not abandonment of rights.
Worked rule of thumb: Before sharing any patient information, ask: does the patient permit it, does the law require it, and is it the minimum necessary? If any answer is no, do not disclose.