Hippocrates to HIPAA: a foundation for a federal physician-patient privilege (original) (raw)

Abstract

The physician-patient privilege allows a patient to prevent his or her physician from revealing in court, as a witness, confidential information communicated to the physician during the course of professional treatment. 2 ScoTr N. STONE & ROBERT K. TAYLOR, TESTIMONIAL PRIVILEGES, §7.01 at 7 (2d ed. McGraw-Hill 1995). The right to assert the privilege generally belongs solely to the patient who may waive it even when the physician would rather not testify to matters revealed during the course of treatment. Id. at 8. 3. See Whalen v. Roe, 429 U.S. 589, 602 n.28 (1977) (noting that "physician-patient privilege is unknown to the common law"); Patterson v. Caterpillar, Inc., 70 F.3d 503, 506-07 (7th Cir. 1995) (stating that federal common law does not recognize physician-patient privilege); Gilbreath v. Guadalupe Hosp. Found., 5 F.3d 785, 791 (5th Cir. 1993) (concluding that physician-patient privilege does not exist under federal law). 4. 277 U.S. 438 (1928). 5. Id. at 472. 6. Id. at 473 (quoting Weems v. U.S., 217 U.S. 349,373 (1910)). 7. Specifically, absent a federal physician-patient privilege, physicians can' be compelled by a federal court to give testimony, based on' information they obtained thi'ough confidential communications with their patientsinformation that might be beneficial in court proceedings, but could be damaging to their patients. STONE & TAYLOR, supra note 2, at 7.

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References (145)

  1. HIPAA § 264(c)(2), 110 Stat. at 2033-34;
  2. C.F.R § 164.512(e).
  3. Id. § 264(c)(2), 110 Stat. at 2033-34 (emphasis added).
  4. 45 C.F.R. § 160.202(1).
  5. Nat'l Abortion Fed'n v. Ashcroft, No. 04-C-55, 2004 U.S. Dist. LEXIS 1701, at *8 (N.D. Ill. Feb. 5, 2004) (citing 45 C.F.R. § 160.202).
  6. Nat'l Abortion Fed'n, 2004 U.S. Dist. Lexis 1701, at *13 (citing Wisconsin Bell, Inc. v. Bie, 340 F.3d 441 (7th Cir. 2003)).
  7. HIPAA § 264(c)(2), 110 Stat. at 2033-34.
  8. Id. (emphasis added).
  9. HeinOnline --77 Temp. L. Rev. 533 2004
  10. Id. (quoting Trammel, 445 U.S. at 47).
  11. Id. (quoting Trammel, 445 U.S. at 50).
  12. Jaffee, 518 U.S. at 9-10.
  13. Id. at 15.
  14. See id. at 11 (discussing importance of serving private interests).
  15. See Jaffee, 518 U.S. at 12-13 ("[W]e recognized that it is appropriate to treat a consistent body of policy determinations by state legislatures as reflecting both 'reason' and 'experience."' (citing Funk v. United States, 290 U.S. 371, 376-81 (1933))).
  16. Id. at 10 (quoting Trammel, 445 U.S. at 51).
  17. HeinOnline --77 Temp. L. Rev. 542 2004
  18. Id. (quoting Upjohn Co. v. United States, 449 U.S. 383,389 (1981)).
  19. Id. (quoting Upjohn, 449 U.S. at 389).
  20. Id. (quoting Trammel, 445 U.S. at 53).
  21. Id.
  22. Id.
  23. See id. at 11 (noting that "[tihe mental health of our citizenry, no less than its physical health, is a public good of transcendent importance").
  24. Id. 2004] HeinOnline --77 Temp. L. Rev. 543 2004
  25. See BRODY ET AL., supra note 313, at 174-75 (discussing relationship between privacy of medical information and Fourth Amendment).
  26. Id. at 175.
  27. See, e.g., Alberts v. Devine, 479 N.E.2d 113, 118-19 (Mass. 1985) (noting that patients rely on fact that physician-patient privilege is confidential (citing MacDonald v. Clinger; 446 N.Y.S.2d 801, 802 (N.Y. App. Div. 1982
  28. See id. at 471-85 (Brandeis, J., dissenting) (arguing that constitutional clauses affording individual protection must adapt to new circumstances).
  29. Id. at 472 (quoting Weems v. United States, 217 U.S. 349,373 (1910)).
  30. Olmstead, 277 U.S. at 473 (Brandeis, J., dissenting) (quoting Weems v. United States, 217
  31. U.S. 349,373 (1910)).
  32. Id. 351. 533 U.S. 27 (2001).
  33. See Michelle M. Mello, Malpractice Liability and Medical Error Prevention: Strange Bedfellows?, Paper prepared for the Council on Health Economics and Policy, Conference on Medical Malpractice in Crisis: Health Policy Options 8 (March 2003) (noting that physicians are leaving or limiting their scope of practice due to the high cost of liability insurance resulting from medical malpractice lawsuits), available at http://www.allhealth.org/recent/audio\_09-29-03/malpracticeAnd Errors-Mello.pdf.
  34. CONGRESSIONAL BUDGET OFFICE, LIMITING TORT LIABILITY FOR MEDICAL MALPRACTICE 3-4 (Jan. 8, 2004), available at http://www.cbo.gov/ftpdocs/49xx/doc4968101-08- MedicalMalpractice.pdf.
  35. Id.
  36. U.S. DEP'T OF HEALTH AND HUMAN SERVS., CONFRONTING THE NEW HEALTH CARE CRISIS: IMPROVING HEALTH CARE QUALITY AND LOWERING COSTS BY FIXING OUR MEDICAL LIABILITY SYSTEM 4 (July 24, 2002), available at http://aspe.hhs.gov/daltcp/reports/litrefm.pdf.
  37. See id. at 7 (noting that cost of malpractice increases amount the federal government and taxpayers must pay by $28.6-47.5 billion per year).
  38. Mello, supra note 379, at 8.
  39. See, e.g., Nightline: A Dying Practice: What Happens When Doctors Go Out of Business (ABC television broadcast, July 25, 2002) (reporting that some doctors cannot continue to practice medicine due to increased insurance premiums), available at LEXIS, News library, ABC News File. See also Gayle Worland, Doctors Flee Insurance Costs, State, CHI. TRB., Mar. 12, 2004, at C1 (reporting that many doctors, particularly obstetricians, have been forced to move their practices to states with lower insurance costs).
  40. See Bruce Japsen, Doctors Risk Practicing Without Costly Insurance, CHI. TRIB., Mar. 18, 2004, at C1 (stating that some physicians are opting to practice without insurance coverage rather than pay high premiums). 2004] HeinOnline --77 Temp. L. Rev. 555 2004
  41. See id. at 82,463 (explaining that assurance of confidential communications between patient and physician ensures that high-quality healthcare will be provided).
  42. See supra notes 46-78 and accompanying text (discussing the rationale behind recognition of a federal physician-patient privilege).
  43. Standards for Privacy II, 65 Fed. Reg. at 82,467. 2004] HeinOnline --77 Temp. L. Rev. 561 2004
  44. The following states have adopted a physician-patient privilege: Alaska, ALASKA R. EVID. 504;
  45. Arizona, ARIz. REV. STAT. ANN. § 12-2235 (West 2003);
  46. Arkansas, ARK. CODE ANN. § 16-41- 101, R. 503 (Michie 1999);
  47. California, CAL. Ev1D. CODE § § 990-1007 (West 1995);
  48. Colorado, COLO. REV. STAT. § 13-90-107(d) (2003);
  49. Delaware, DEL. UNIF. R. EVID. 503; District of Columbia, D.C. CODE ANN. § 14-307 (2001);
  50. Georgia, GA. CODE ANN. § 24-9-40 (1995);
  51. Hawaii, RAW. R. EViD. 504; Idaho. IDAHO CODE § 9-203.4 (Michie 2004);
  52. Illinois, 735 ILL. COMP. STAT. ANN. § 5/8-802 (2004);
  53. Indiana, IND. CODE ANN. § 34-46-3-1 (West 2004);
  54. Iowa, IOWA CODE ANN. § 622.10 (West 1999);
  55. Kansas, KAN. STAT. ANN. § 60-427 (Supp. 2004);
  56. Louisiana, LA. CODE EVID. ART. 510 (West 2004);
  57. Maine, ME. R. EvID. 503; Michigan, MICH. COMP. LAWS ANN. § 600.2157 (West 2000);
  58. Minnesota, MINN. STAT. ANN. § 595.02(1)(d) (West 2000);
  59. Mississippi, MISS. CODE ANN. § 13-1-21 (1999);
  60. Missouri, Mo. ANN. STAT. § 491.060(5) (West 1996);
  61. Montana, MONT. CODE ANN. § 26-1-805 (2000);
  62. Nebraska, NEB. REV. STAT. § 27-504 (1995);
  63. Nevada, NEV. REV. STAT. ANN. § § 49.215-.245 (Michie 2002);
  64. New Hampshire, N.H. REV. STAT. ANN. § 329:26 (1995);
  65. New Jersey, N.J. STAT. ANN. § 2A:84A-22.2 (West 1976);
  66. New York, N.Y. C.P.L.R. 4504(a) (McKinney 1992);
  67. North Carolina, N.C. GEN. STAT. § 8-53 (2003);
  68. North Dakota, N.D. R. EvID. 503; Ohio, OHIO REV. CODE ANN. § 2317.02(B) (Anderson 2001);
  69. Oklahoma, OKLA. STAT. ANN. tit. 12, § 2503 (1993);
  70. Oregon, OR. REV. STAT. ANN. § 40.235 (Butterworth 1988);
  71. Pennsylvania, PA. CONS. STAT. ANN. tit. 42, § 5929 (West 1982);
  72. Rhode Island, R.I. CODE R. § 5-37.3-4 (2002);
  73. South Dakota, S.D. CODIFIED LAWS § § 19-13-6 to -11 (Michie 1987);
  74. Texas, TEx. R. EVID. 509 (West 2004);
  75. Utah, UTAH CODE ANN. § 78-24-8(4) (2002);
  76. Vermont, VT. STAT. ANN. tit. 12, § 1612(a) (2002);
  77. Virginia, VA. CODE ANN. § 8.01-399 (Michie 2000);
  78. Washington, WASH. REV. CODE ANN. § 5.60.060(4) (West 1995);
  79. Wisconsin, Wis.
  80. STAT. ANN. § 905.04 (West Supp. 2000);
  81. Wyoming, Wvo. STAT. ANN. § 1-12-101(a)(i) (Michie 2003).
  82. See Broun, supra note 305, at 807 (noting that federal rules are, to some extent, representative of general state of State law).
  83. Jaffee, 518 U.S. at 14.
  84. Robert A. Wade, Note, The Ohio Physician-Patient Privilege: Modified, Revised, and Defined, 49 OHIO ST. L.J. 1147, 1148 (1989) (citing N.Y. REV. STAT. 406, § 73 (1828)). Despite the Bush Administration's weakening of privacy protections under
  85. Id.
  86. Id.
  87. See id. (noting that "the health insurance portability law ... was an important first step, but we must go further").
  88. See Thomas: Legislative Information on the Internet, LIBRARY OF CONGRESS WEB SITE, at http://thomas.loc.gov (last visited May 9, 2004) (providing searchable database of Congressional bills).
  89. See, e.g., Stop Taking Our Health Privacy Act of 2003, H.R. 1709, 108th Cong. (2003) (restoring "standards to protect the privacy of individually identifiable health information");
  90. Medical Independence, Privacy, and Innovation Act of 2003, H.R. 2544, 108th Cong. (2003) (intending "to improve the quality, availability, diversity, personal privacy, and innovation of health care in the Unites States"); Patient Safety and Quality Improvement Act of 2004, H.R. 663, 108th Cong. (2003) (attempting "to provide for the improvement of patient safety and to reduce the incidence of events that adversely affect patient safety"); Defense of Privacy Act, H.R. 338, 108th Cong. (2003) (requiring that "agencies, in promulgating rules, take into consideration the impact of such rules on the privacy of individuals");
  91. Patient Privacy Act, H.R. 1699, 108th Cong. (2003) (repealing sections 1173(b) and 1177(a)(1) of the Social Security Act); Equal Rights and Equal Dignity for Americans Act of 2003, S.
  92. 108th Cong. (2003) (authorizing Attorney General, upon request, to provide assistance with investigation or prosecution of violent and hate based crimes);
  93. Health Information for Quality Improvement Act, S. 2003, 108th Cong. (2003) (intending to "promote higher quality health care and better health by strengthening health information, its infrastructure, and its use by clinicians and consumers");
  94. Better HEALTH Act of 2003, S. 1374, 108th Cong. (2003) (enhancing patient access to care through direct assistance);
  95. Health Care Coverage Expansion and Quality Improvement Act of 2003, S. 10, 108th Cong. (2003) (attempting to improve managed care by increasing access to information and care).
  96. S. 1053, 108th Cong. (2003).
  97. NAT'L HUMAN GENOME RESEARCH INST., supra note 454.
  98. See ELECTRONIC PRIVACY INFO. CENTER, MEDICAL PRIVACY: GENETIC INFORMATION (detailing impact of Genetic Information Nondiscrimination Act of 2003), at http://www.epic.org/ privacy/medical/ (last visited Dec. 28, 2004).
  99. Id. 2004] HeinOnline --77 Temp. L. Rev. 567 2004
  100. See supra notes 73-78 and accompanying text (discussing 2002 modifications to HIPAA Privacy Rule).
  101. White House News Release, Today's Presidential Action (June 2001) (summarizing President's call for legislative action to prevent genetic discrimination), available at http://www.whitehouse.gov/news/releases2001/06/20010623-2.html (last visited Dec. 28,2004).
  102. See NAT'L HUMAN GENOME RESEARCH INST., POLICY AND LEGIS. DATABASE (providing searchable database of federal and state laws pertaining to "privacy of genetic information/confidentiality; informed consent; insurance and employment discrimination; genetic testing and counseling; and commercialization and patenting"), at http://www.genome.gov/ [Vol. 77
  103. HeinOnline --77 Temp. L. Rev. 568 2004
  104. See id. (providing summary of federal and state laws dealing with genetic discrimination). See also NAT'L HUMAN GENOME RESEARCH INST., GENETIC DISCRIMINATION IN HEALTH INS. OR EMP. (providing links to other sources on genetic nondiscrimination legislation), at http://www.genome.gov/11510227 (last visited Nov. 12 2004).
  105. See NAT'L HUMAN GENOME RESEARCH INST., supra note 470 (outlining types of protection varying state laws provide).
  106. E.g., ARIz. REV. STAT. ANN. § 12-2802(A)(2) (West 2003) (requiring written authorization for release of genetic testing information).
  107. E.g., id. § 12-2802(A) (stating that information derived from genetic testing is confidential and privileged).
  108. E.g., DEL. CODE ANN. tit. 16, § §1224(a), 1227 (2003) (prohibiting disclosure of genetic information in response to subpoena and establishing penalties for violation of statute).
  109. E.g., Genetic Information Privacy Act, 410 ILL. COMP. STAT. ANN. 513/15 (West 2003) (prohibiting discovery or admission of genetic testing and information derived from genetic testing in any legal proceeding except in specifically identified circumstances).
  110. E.g., id. at 513/40 (authorizing private cause of action for unauthorized disclosure of genetic testing information).
  111. HeinOnline --77 Temp. L. Rev. 569 2004
  112. Lovato v. BurlingtonN. & Santa Fe R.R. Co., No. 00-M-2584, 2001 U.S. Dist LEXIS 7924, at *4-5 (D. Colo. May 4,2001).
  113. Id. at *1 (emphasis added).
  114. Id.
  115. Lovato, 2001 U.S. Dist. LEXIS 9002, at *1.
  116. Id. at *19-20. 490. 18 U.S.C. § 1531 (2003).
  117. Northwestern Mem'l Hosp., 362 F.3d at 932-33.
  118. No. C 03-4872 PJH, 2004 U.S. Dist. LEXIS 3383 (N.D. Cal., Mar. 5, 2004), injunction granted, 320 F. Supp. 2d 957. [Vol. 77
  119. HeinOnline --77 Temp. L. Rev. 570 2004
  120. Planned Parenthood Fed'n of Am., 2004 U.S. Dist. LEXIS 3383, at *7.
  121. See Jaffee, 518 U.S. at 10-11 (noting that protecting willingness of patients to confide in psychotherapist serves both public and private interests).
  122. See supra note 8 for a discussion of the origins of the Hippocratic Oath and the relevant text regarding doctor patient confidentiality. 503. Id.
  123. BOYLE & MACK, supra note 313, at 1:4.
  124. See BRODY, ET AL., supra note 313, at 170 (discussing origins of physician-patient confidentiality and its importance in modern medicine).
  125. Id. at 171.
  126. See id. at 179-87 (listing medical groups that have issued statements regarding confidentiality). 2004] HeinOnline --77 Temp. L. Rev. 571 2004
  127. BARRY R. FURROW ET AL., HEALTH LAW 148 (2d ed. 2000).
  128. See generally CODES OF PROFESSIONAL RESPONSIBILITY: ETHics STANDARDS IN BUSINESS, HEALTH, AND LAW (Rena A. Gorlin ed., 4th ed. 1999) (containing codes of ethics stressing importance of confidentiality for various health care professions).
  129. See, e.g., id. at 312 (noting American College of Physicians' description of confidentiality as a fundamental tenant of medicine).
  130. See Jaffee, 518 U.S. at 10 n.9 (relying on amici curiae brief by American Psychiatric Association and American Psychological Association). See also id. at 13 n.12 (relying upon ethical principles of psychologists and social workers in asserting that "any State's promise of confidentiality would have little value if the patient were aware that the privilege would not be honored in federal court").
  131. See supra note 446 for the text of Uniform Rule of Evidence 503.
  132. See supra note 19 and accompanying text (noting that Federal Rules of Evidence do not recognize physician-patient privilege).
  133. See Jaffee, 518 U.S. at 14-15 (noting that States' support for psychotherapist-patient privilege is reinforced by inclusion of privilege in recommendations to Advisory Committee). [Vol. 77
  134. HeinOnline --77 Temp. L. Rev. 572 2004 522
  135. Id. at 8 (quoting S. REP. No. 93-1277, p. 13 (1974)).
  136. See In re Grand Jury Investigation, 918 F.2d 374, 380 (3d Cir. 1990) (noting only that "the proposed rules provide a useful reference point and offer guidance in defining the existence and scope of evidentiary privileges in the federal courts") (emphasis added).
  137. See supra notes 298-300 and accompanying text (discussing how Jaffee went beyond scope of proposed Federal Rule of Evidence 504).
  138. FED. R. EVID. 505(b) (proposed 1973).
  139. Noted scholar and legal educator John Henry Wigmore wrote the seminal treatise on Evidence (1904 and 1940).
  140. 8 JOHN HENRY WIGMORE, 8 EVIDENCE IN TRIALS AT COMMON LAW § 2285 (John T. McNaughton rev., Little, Brown & Co. 1961) (1904). This long-established test pre-dates the FRE and Jaffee. Wigmore first discussed this test in Evidence in Trials at Common Law (Little Brown 1940).
  141. WIGMORE, supra note 522, at § 2285. 524. Id. at § 2380a.
  142. See id. (noting there are few instances where communications between physician and patient are confidential).
  143. WIGMORE, supra note 522, at § 2380a. 529. Id. at § 2380a(4).
  144. See supra notes 19-22 and accompanying text for a discussion of how the Supreme Court's recognition of a psychotherapist-patient privilege in Jaffee demonstrates that there should also be a physician-patient privilege. [Vol. 77
  145. HeinOnline --77 Temp. L. Rev. 574 2004