When there is a Breach of Privacy, has a Breach of Fiduciary Duty Occurred?

With the HIPAA laws, much emphasis has been placed on the patient’s privacy rights and the requirements of the health care organization (a covered entity) to ensure privacy of protected health information. Discuss the following: When there is a breach of privacy, has a breach of fiduciary duty occurred? 

When there is a breach of privacy, has a breach of fiduciary duty occurred?

Fiduciary duty refers to the party’s responsibility to act in the best interest of another party.  Fiduciary law oversees relationships wherein one party has discretionary power over the important practicalconcern of another party. In healthcare industry, health care professionals have fiduciary duty toward their organization and patients. The patient-physician relationship has been acknowledged as one amongst other categories of traditionally recognized fiduciary relationship. In most cases liability is based on violation of the fiduciary duty of loyalty, an obligation that needs the fiduciary to properly manage or avoid conflicts of interest. This duty entails situations where the beneficially interest; patient, might conflict with the fiduciary self-interest or the duty of fiduciary to serve third-party interest.

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Fiduciaries in healthcare setup are also said to work under duty of confidentiality, care, disclosure and discretion. The care duty needs the fiduciary to demonstrate reasonable care, skill and diligence while exercising judgment and any action related to the judgment. The discretion duty needs the exercise of judgment by fiduciary in beneficially (patient) best interest. The disclosure duty needs fiduciary to disclose records, mistakes, and conflict of interest among other information that is important to professional power exercise. The confidentiality duty limits the fiduciary’s disclosure and use of confidential information of beneficiary and demands taking reasonable steps to safeguard patient information confidentiality. The combination of these fiduciary duties results to duty of data and information security which is fully taken by the healthcare organization and its workers to safeguard patients (Miller, Choudhry& Campbell, n.d.).

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The HIPAA law covers right to privacy, personal data protection and medical confidentiality. According to Knoppers (2000), privacy continues to develop personal intimacy zone free from public analysis. Medical confidentiality arises from the fiduciary character of patient-physician relationship and nature of the concerned information. In addition recent personal data protection laws enactment assist in shielding people for informatics power though it also offers a measure of personal control and security.  Personal data protection, confidentiality and privacy in health information are inseparable. The ethical requirement of medical professional to exercise information confidentiality and the legal requirement to enhance data protection and privacy gives healthcare organization the fiduciary duty towards its patient. They have a duty of care to protect the privacy, confidentiality and ensure security of patient healthcare information.

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Breach of this the HIPAA law thus results to the breach of fiduciary duty law which holds the healthcare organization or a specific physician liable for the act. For a breach of privacy to qualify to be breach of fiduciary duties breach of patient healthcare data or information privacy must be done for the best interest of the third party or the physician, nurse or any other medical professional, but not on  the best of the patient.  Patient information can sometime be shared among professionals at reasonable level in an attempt to define the best healthcare measure to assist the patient in the treatment and effective care. This is normally done with patient consent and hence, this is not regarded as breach of fiduciary duty. However, when this is done to assist a third party or for other purpose mostly related to professional benefits, then there is breach of fiduciary duty and the medical professional or the healthcare organization is liable for dishonoring the duty of care given to them by the patient.

Read also Patient Safety and Quality Improvement Act of 2005

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