No abstract available.
Confidentiality* ; Informatics*

To investigate the attitude towards the security, privacy, and confidentiality of health information, authors surveyed patient, physician, nurse, medical student, nursing student, medical record manager, and health management student groups. Most of the subject hoped that the health information should be treated as a secret. They answered that the information could be shared for the social good when necessary, the ownership and the right to decide the disclosure should belong to patient, and patient should be allowed to access their own information with certain degree of regulation. More than half of the clinical workers answered that they have disclosed patient' s secret for non-medical reasons within a year but they denied any potential harm to their patients. Patients expected that their health information were being securely treated, gave the lowest grade to security violation risk, and showed the most generous attitude towards disclosing and sharing their information than other groups. However, when they are asked the same questions for detailed items such as identification, diagnosis, cause of admission, past medical history and so forth, they showed the strictest attitude to most of the situations and items to disclose their information. Different attitudes toward the information security among the different social groups was demonstrated as a potential cause of social conflict. The attitude change of the patients with the different level of granularity of questions suggests that investigators should be cautious when they conduct and interpretate the attitude toward the security, privacy, and security aspects of health information.
Confidentiality* ; Diagnosis ; Disclosure ; Hope ; Humans ; Medical Records ; Ownership ; Privacy* ; Research Personnel ; Students, Medical ; Students, Nursing

Adolescent ; Child ; Confidentiality ; Congenital Abnormalities ; Disclosure ; Humans ; Pediatrics ; ethics ; Psychology, Adolescent

PURPOSE: The aim of this study was to inquire about the clinical performance and determine the performance pattern of medical students in standardized patient (SP) based examinations of domestic violence (DV). METHODS: The clinical performance sores in DV station with SP of third-year (n=111, in 2014) and 4th-year (n=143, in 2016) medical students of five universities in the Busan-Gyeongnam Clinical Skills Examination Consortium were subjected in this study. The scenarios and checklists of DV cases were developed by the case development committee of the consortium. The students’ performance was compared with other stations encountered in SP. The items of the checklists were categorized to determine the performance pattern of students investigating DV into six domains: disclosure strategy (D), DV related history taking (H), checking the perpetrator’s psychosocial state (P), checking the victim’s condition (V), negotiating and persuading the interviewee (N), and providing information about DV (I). RESULTS: Medical students showed poorer performance in DV stations than in the other stations with SP in the same examination. Most students did confirm the perpetrator and commented on confidentiality but ignored the perpetrator’s state and patient’s physical and psychological condition. The students performed well in the domains of D, H, and I but performed poorly in domains P, V, and N. CONCLUSION: Medical students showed poor clinical performance in the DV station. They performed an ‘event oriented interview’ rather than ‘patient centered’ communication. An integrated educational program of DV should be set to improve students’ clinical performance.
Checklist ; Child ; Child Abuse ; Clinical Competence ; Confidentiality ; Disclosure ; Domestic Violence* ; Education, Medical, Undergraduate ; Humans ; Negotiating ; Students, Medical

This paper covered a variety of issues that fall under the general rubric of ethical considerations in clinical psychopharmacologic research. The topics of ethical of subject selection and confidentiality, medication-free research. informed consent for those humans exposed to psychotropic drug research, and possible conflicts of interest in medical researcher/pharmaceutical sponsor were reviewed. Beginning with a brief section on the justifications for engaging in research, this review indentified the codflicts that inevitably arise between society's need for reliable and valid research and our obligation to protect subjects. Also author reviewed the patient consent issues, including the essential elements of informed consent, populations requiring surrogate consent, and confidentiality requirements. The paper continued with a discussion of responsible research practices, including the medication-free research, and conflicts of relationship between researcher and sponsor. In spite of a number of ethical dilemmas in clinical trials, the willingness of the scientist to confront the ambiguities of ethical questions in the pursuit of scientific knowledge reveals a basic truth, that is, the ethical characteristics of the scientist who undertakes such a task. Although it would be impossible to assure the general population that all researchers are ethical, it is incumbent on us to educate future researchers and provide practical guidelines for maintaining the primary ethical values of the individual who performs research with humans.
Confidentiality ; Ethics* ; Humans ; Informed Consent

OBJECTIVES: This study is designed to discuss the pros and cons related to the 'separation of drug prescription and dispensation' system when 5 years have passed by since the introduction of this system. METHODS: The 592 psychiatrists from 1,107 working places took part in nationwide survey by mail or E-mail from June to September, 2005. The response rate was 23.8%, most of respondents came from private clinics. RESULTS: The average age of psychiatrist was 44.6 years old, ranging from 25 to 75, most of them was predominantly male. The main results were as followings: 1) The ratio of psychiatric prescription out of hospital based on out-patients departments was the lowest in clinics, following by hospitals, general hospitals and university hospitals by order. 2) The main reasons of customer's preference for out of hospital prescription were economic advantage and self-awareness of prescription. As for the disliking for it, the most complaints were the anxiety about disclosure of psychiatric treatment, in convenience for delay and concern about drug change. CONCLUSION: Five years didn't seem to give a change on how the psychiatrists perceive the 'separation of drug prescription and dispensation' system at all. The confidentiality and human right issues on the part of psychiatric patients should never be ignored in order to manage this system successfully.
Anxiety ; Confidentiality ; Surveys and Questionnaires ; Disclosure ; Drug Prescriptions* ; Electronic Mail ; Follow-Up Studies* ; Hospitals, General ; Hospitals, University ; Human Rights ; Humans ; Male ; Outpatients ; Postal Service ; Prescriptions ; Psychiatry

he successful completion of Human Genome Project (HGP) and further advances in genomic research and technology ushered a new era of genetic medicine in the 21st century. The discovery of a gene-disease association lays the groundwork for the development of a genetic test. Clinical applications of genetic information and tools have provided us with the ability to perform a wide range of DNA testing for the diagnosis of various genetic diseases in patients as well as predicting the disease and disease susceptibility among presymptomatic family members at risk. Thus, the introduction of a new genetic testing may have complex implications for patients, family members, and the society. Guidelines for genetic testing have been developed not only to insure the accuracy of testing with the analytical validity, clinical validity, and clinical utility itself, but also to provide an implicit guide to ethical, legal and social issues (ELSI). Non-directive genetic counseling prior to genetic testing can provide patients with clinical implications of testing in terms of its benefits as well as risks, and help the patient to prepare informed consent, while efforts are made to insure privacy and confidentiality of individual genetic information. Ensuring the appropriate use of genetic testing in Korean health delivery system requires multidisciplinary efforts for the development of practice guidelines and educational programs for clinical genetics professionals including genetic counselors as well as governmental regulatory implementation for ELSI of genetic testing.
Confidentiality ; Counseling ; Diagnosis ; Disease Susceptibility ; DNA ; Genetic Counseling* ; Genetic Testing* ; Genetics ; Human Genome Project ; Humans ; Informed Consent ; Privacy

PURPOSE: Upward feedback is becoming more widely used in medical training as a means of quality control. Multiple biases exist, thus the accuracy of upward feedback is debatable. This study aims to identify factors that could influence upward feedback, especially in medical training. METHODS: A systematic review using a structured search strategy was performed. Thirty-five databases were searched. Results were reviewed and relevant abstracts were shortlisted. All studies in English, both medical and non-medical literature, were included. A simple pro-forma was used initially to identify the pertinent areas of upward feedback, so that a focused pro-forma could be designed for data extraction. RESULTS: A total of 204 articles were reviewed. Most studies on upward feedback bias were evaluative studies and only covered Kirkpatrick level 1-reaction. Most studies evaluated trainers or training, were used for formative purposes and presented quantitative data. Accountability and confidentiality were the most common overt biases, whereas method of feedback was the most commonly implied bias within articles. CONCLUSION: Although different types of bias do exist, upward feedback does have a role in evaluating medical training. Accountability and confidentiality were the most common biases. Further research is required to evaluate which types of bias are associated with specific survey characteristics and which are potentially modifiable.
Bias (Epidemiology) ; Confidentiality ; Quality Control ; Social Responsibility

With the development of high-throughput technologies, biomedical data has been increasing exponentially in an explosive manner. This brings enormous opportunities and challenges to biomedical researchers on how to effectively utilize big data. Big data is different from traditional data in many ways, described as 3Vs - volume, variety and velocity. From the perspective of biomedical research, here I introduced the characteristics of big data, such as its messiness, re-usage and openness. Focusing on microbiome research of meta-analysis, the author discussed the prospective principles in data collection, challenges of privacy protection in data management, and the scalable tools in data analysis with examples from real life.
Biomedical Research ; Confidentiality ; Data Collection ; methods ; Microbiota

CONTEXT: Evolution of the scope and context of privacy and confidentiality brought about by use of information and communications technology in healthcare.

OBJECTIVE: To review the legal, professional and ethical landscape of health information privacy in the Philippines.

METHODOLOGY: Systematic review of literature and policy frameworks.

RESULTS: Philippine laws jurisprudence recognize and protect privacy of health information as a general rule; impose upon individual practitioners and institutions the obligation to uphold such right; and may apply in both the traditional and eHealth milieu. There is no existing policy framework that addresses issues relating to [a] access to health information by non-health professionals, [b] use of health information for non-health purposes, and [c] rules relating to collection, storage and utilization of electronically-derived or -stored information. A privacy culture, on either the provider's or client's side, is also lacking in the country.

CONCLUSION: Technological developments have outpaced policy and practice. There is a need to unify the patchwork of regulations governing the privacy of health information; advocate for a privacy culture among professionals and patients alike; fortify the evidence base on patient and provider perceptions of privacy; and develop and improve standards and systems to promote health information privacy at the individual and institutional levels.