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Family Physician
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VignettePlease read the vignette below and respond to it

Resolved Question:

Vignette
Please read the vignette below and respond to it by Day Six. You MUST apply an appropriate ethical decision making model from Bersoff or apply another ethical decision making model which you may prefer (e.g., Canadian Psychological Association; NASP, etc.). Use the steps of the decision making model to discuss your decision making process.

The Inpatient




You have been working with a patient for a few weeks, when she comes to her appointment in an agitated state. You decide to refer her to an inpatient facility because her behavior has become very unreliable. She is not overtly suicidal or homicidal. When you call the facility the next day to check on her status, the hospital will neither confirm nor deny that she is a patient there. You have a generic release form that she signed when you started working with her a couple of weeks previously.



Please address the following questions (note: see additional question below):



Can you use the previously signed form to get information about your client?



Can you fax the release form to the clerk at the hospital?



ADDITIONALLY: Prior to your decision to refer her for inpatient treatment, the client was engaged in abusing prescription medication. She was taking the Xanax that her physician had prescribed for her much more quickly than the prescribed dosage. In fact, she had taken 17 mg in the 30 hours prior to admission. She should have only taken 2.5 mg.



Please also address the following question:



Does this change anything?
Submitted: 4 years ago.
Category: Homework
Expert:  Josie-Mod replied 4 years ago.

Hi, I'm a Moderator for this topic and I wonder whether you're still waiting for an answer. If you are, please let me know and I will do my best to find a Professional to assist you right away. If not, feel free to let me know and I will cancel this question for you. Thank you!

Customer: replied 4 years ago.
Yes,but it is due tomorrow.can someone be able to do something
Expert:  Josie-Mod replied 4 years ago.

Hi,


Thank you for your reply. Sometimes, finding the right Professional can take a little longer than expected and we thank you greatly for your understanding. We'll be in touch again shortly.

Expert:  Family Physician replied 4 years ago.
Thank you for your question: I will be happy to give you some general thoughts and direction with this is you are interested. I do not however do complete assignments, since this would not help you learn from the course.

Would this meet your needs?
Customer: replied 4 years ago.
Ok, that will be fine
Expert:  Family Physician replied 4 years ago.
Can you use the previously signed form to get information about your client?
A release (under HIPAA regulations these are now called Authorizations) is only valid if the individual includes the specific information that may be released. Since the form was signed before this particular episode, the patient would not have known (or could not have known) that she was going to have these particular symptoms or hospitalization. Unless the form specifically mentioned "any and all future psychiatric care" or something to this effect, there is no basis to assume that the consent for such potential future information was included in the release.



Can you fax the release form to the clerk at the hospital?

This question reminds me of the important distinction between "can" and "may". You COULD fax the release, however you MAY not from an ethic point of view. The clerk might not be aware of the limitations of this "generic" release, which could lead the clerk to honor your inappropriate request for release of information.

One solution to this problem would be for you to ask the clerk something like this;
I understand you can not confirm if Ms X is a patient at your facility, but I would appreciate if you would ask this individual if you could release information to me IF she is a patient at your facility. I will call back later, and would appreciate if you could give me information about this patient IF she consents to such a release. If she does not consent, I understand that you can't tell me that she is a patient, and would not be able to tell me that she had refused to give her consent. (I have worked for years in the ER, and we often get this type of problem; someone calls to see someone is in the ER. I typically put them on hold, ask the patient if they would like to speak with the person or would like me to speak with the person on the phone. If they agree, I tell them the person is a patient in the ER. If they don't agree, I tell them, "I'm sorry, by federal law we aren't able to tell you anything. We can't even tell you if someone is or is not in our ER)



ADDITIONALLY: Prior to your decision to refer her for inpatient treatment, the client was engaged in abusing prescription medication. She was taking the Xanax that her physician had prescribed for her much more quickly than the prescribed dosage. In fact, she had taken 17 mg in the 30 hours prior to admission. She should have only taken 2.5 mg. Does this change anything?

 

In this case, you are not actually requesting information, you have information that the attending physician/staff would appropriately need to consider in treating the patient. If you considered this information to be serious enough to represent a clear danger to the health or wellbeing of the patient, you may have an obligation (at least ethically) to provide the information to the facility.


 

Family Physician, Tutor
Category: Homework
Satisfied Customers: 12816
Experience: Tutor in many fields since college. Physician with MBA
Family Physician and 3 other Homework Specialists are ready to help you
Customer: replied 4 years ago.
pls can you send me a reference.thank you so much for you help
Expert:  Family Physician replied 4 years ago.
Here is a reference in regards XXXXX XXXXX HIPAA regulations on releasing information without an Authorization
http://www.hhs.gov/ocr/privacy/hipaa/faq/authorizations/481.html

Here is the HIPAA reference in regards XXXXX XXXXX that was created after a signed Authorization
http://www.hhs.gov/ocr/privacy/hipaa/faq/authorizations/477.html

These reference apply to the LEGALITY (not specifically the ethical issue)
Expert:  Family Physician replied 4 years ago.
THIS ANSWER IS LOCKED!

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