Every day of the year, individuals are admitted to a medical care facility whether it be a hospital, infirmary, or some variation of an entity designed to provide medical help. Within the confines of these facilities, the patients are placed in situations where their privacy is compromised. The Google Dictionary defines privacy as: “the state or condition of being free from being observed or disturbed by other people.” The legal definition included in the Merriam-Webster Dictionary is: “Freedom from unauthorized intrusion: state of being let alone and able to keep certain especially personal matters to oneself.” These definitions are included to provide a backdrop to what goes on day-in and day-out in medical facilities throughout the country. Recently, my wife was admitted to the hospital and was placed, against her requests, in a semi-private room. The patient’s privacy is violated throughout the patients’ stay in a semi-private room. To argue that a flimsy curtain separating the two beds assures privacy is farcical. During times that I was visiting my wife, I became aware of the various ailments of the patient in the other bed. I know that she was diabetic, had gout, was incontinent, and unable to walk without assistance. My wife described the bathroom, which they had to share, as a disaster, including dirty diapers lying on the floor. While we were cognizant of the women’s condition, she and her husband were, no doubt, aware of my wife’s condition. A curtain does little to muffle conversation and provide any modicum of privacy. We continued to request a private room but did not get one until the third day of her hospitalization.
Indeed, privacy has become an important concept in the age of the Internet. How do you protect the privacy of another person? In 1974 the Federal Government passed the Privacy Act and in 1996 the Health Insurance Portability and Accountability Act (HIPAA) became law and included a Privacy Rule section. In a Department of Health and Human Services (HHS) document, the Privacy Rule is discussed. It is noted that the ‘Privacy Rule standards address the use and disclosure of individuals’ health information—called ‘protected health information’ by organizations subject to the Privacy Rule –called ‘covered entities,’ as well as standards for individuals’ privacy rights to understand and control how their health information is used.” Although these laws deal with privacy from a broader perspective, it can be argued that the protection of an individual’s health-specific information fits with the spirit of the laws, if not the letter of the laws. While there is this emphasis on protecting the patients’ health information, it should be noted that there is a concept known as “Incidental Disclosure” which tends to undermine the intent of the protections included in the HIPPA Privacy Rule. It allows for the sharing of medical information in a manner that creates a risk of such information not being protected, i.e., a physician talking to a patient in a semi-private room. Regardless, the patient’s right to privacy should not be compromised for the sake of convenience. This protection must be adhered to in all communications where health-specific information is being discussed.
Protecting a patient’s privacy is impossible in a semi-private room. In Dr. William G. Wilkoff’s article, No Space for HIPAA in My Semi-Private Room, he concluded by stating: “As it stands now, HIPAA in a semi-private room is a bad joke.” For a medical facility to have all private rooms, does create a bit of a financial issue, yet privacy should not be reduced to a matter of dollars. The hospital industry includes some of the primary defenders for having the option of semi-private rooms, yet in the American Hospital Association’s, A Patient’s Bill of Rights, the fifth Right is: “The patient has the right to every consideration of privacy. Case discussion, consultation, examination, and treatment should be conducted so as to protect each patient’s privacy.” The Patients’ Bill of Rights in New York State includes the right to: “Privacy while in the hospital and confidentiality of all information and records regarding your care.” There is a recognition that the privacy of each patient is a right that must be protected.
As noted, there is an inherent principle of privacy that permeates the health care industry and protections must be in place to protect the privacy of the patient. When a person is hospitalized, they are at the mercy of the health care providers. Patients do not loose their right to privacy once they are admitted to a medical facility. It is incumbent on hospital administrators, physicians, nurses and anyone who encounters the patient to recognize their rights and adhere to them, particularly, the right to privacy. Further, regardless of the financial implications, semi-private rooms must become a vestige of the past. Each person has the right to their space and their privacy.