Question

One day at work at Pleasantville Medical Hospital, Dr. Frank Patel notices that a number of the other staff are going to the hospital administrator’s office for 10 minutes at a time. Then Patel gets a call: please come to the administrator’s office at 2:00 p.m. When Patel gets there, he is surprised to find the Hospital’s legal counsel, Janine Chou, is there. Chou explains that she is helping the hospital investigate a violation of HIPAA "privacy" rules. (HIPPAA is the Health Insurance Portability and Accountability Act of 1996. Do not worry about the details of the the law in answering this question.)

Chou asks, “In the last three weeks, have you discussed any of the hospital’s patients with anyone who does not work for the hospital? Have you ever discussed a patient when you were outside the hospital?” Patel truthfully answers that he does not believe he has done so.

Then Chou asks, “Are you aware of any other hospital employee who has done so?” Patel truthfully answers that he cannot think of any such case.

That evening, Patel watches the local news, and is surprised that the lead story is about his hospital’s treatment of a registered "notorious" sex offender. The story reveals that the patient is under treatment for mental health issues. The story gives the name of the patient and says that he has been going to the hospital for treatment for three weeks. Suddenly, Patel realizes that he has heard about this from one of the hospital’s psychiatrists, Dr. Isabella Gardner. He heard about it two weeks before, when he was having dinner with Gardner and her husband and another of the hospital’s doctors at a local restaurant. Gardner had told them that she had a patient who just moved to Pleasantville after having served 20 years of prison time after being found guilty of several sexual assaults at the other end of the state. He could not leave the state while serving probation, but wanted to get away from a place where everyone knew his story. She said that her patient was suffering from depression and sleep problems, but, based on his case file and their conversations, she questioned whether he was actually guilty of the crimes.

At the time, the conversation was just typical “shop talk” between co-workers. However, because the conversation took place in a restaurant, it was possible that other people heard some of what Gardner said. And Gardner’s husband, who did not work at the hospital, certainly heard the details! Who knew how much else Gardner told her husband about patients at work?

Seeing the news report, Patel now realizes that he did not give an accurate answer to Chou about other hospital employees. He did in fact violate HIPAA by listening to Gardner, and he does know of two other employees who violated HIPAA, Gardner and the second doctor who attended the meal.

Your thesis: Should the hospital disclose who it treats as a patient, or is there a moral duty to keep this information confidential? Does Patel have an moral duty to go back to Chou and report the conversation in the restaurant? As a result, both Patel and Gardner might be suspended from work without pay for a week. (Do not concern yourself with the question of their legal obligations.)