Analyzing Ethical Challenges in Managing Behavioral Health Data and Privacy

Behavioral health (BH) presents several specific issues in the field of information technology ethics (Rinehart-Thompson & Randolph, 2015), the importance of which is highlighted by the fact that people with BH issues can be regarded as a vulnerable population (Joy, Clement, & Sisti, 2016). Because of this factor, the ethical dilemmas that are related to BH are numerous and multifaceted (Joy et al., 2016; Hanken & Murphy, 2015), but the issue that is typically taken into consideration is the fact that BH data is very sensitive (Rinehart-Thompson & Randolph, 2015, p. 524). As a result, ethical management and disclosure are particularly important.

As suggested by Ken Goodman, privacy and confidentiality are likely to be the most significant aspects of ethics within the field of information technology. Similarly, Hanken and Murphy (2015) describe these two features as the most important ones. Among other things, the right to privacy of a patient presupposes the protection of the identification of the individual who receives BH-related help; this concern is predominantly guided by the fact that BH is often connected to stigma (Rinehart-Thompson & Randolph, 2015, p. 511). In other words, the information related to BH cannot be disclosed unless it is required from the perspective of the public interest.

The disclosure of BH information is predominantly guided by the law, even though there are cases of law conflict, which are likely to be beyond a health practitioner’s ability to resolve and require legal help (Rinehart-Thompson & Randolph, 2015, p. 513). Apart from that, the American Health Information Management Association’s (2011) code of ethics is instrumental in the ethical management of BH data (Hanken & Murphy, 2015).

Finally, the foundations of ethical management of information seem to be ingrained in the key principles of any medical profession. Indeed, as suggested by Ken Goodman in his speech, ethics and respect are interconnected, and respectful treatment of patients’ rights is the first principle of the American Medical Association’s (2001) Code of Ethics. Moreover, the principles number three, four, and eight can also be connected to ethical information management since they highlight the accountability and responsibility of a health professional concerning the patient.

To sum up, there are codes of ethics that can be used as tools to guide the ethical practice of BH information management. They should provide some assistance in resolving gray-area dilemmas. Also, a tool that can be employed to help in such instances is an ethical dilemma matrix, which is presented in Table 1.

Table 1. Matrix: A general description of the considerations regarding behavioral health (BH) data disclosure based on examples by Hanken and Murphy (2015).
Steps Information
  1. What is the question?
Should the sensitive BH data be disclosed in a particular instance and which data needs to be disclosed?
  1. What is my “gut” reaction?
It depends on the situation.
  1. What are the facts?
Known: the disclosure of the information can harm patients, in particular, through the stigma that is often attached to it. Unless the health professional is legally bound to provide the data, the disclosure of BH information violates the privacy of the patient (Rinehart-Thompson & Randolph, 2015).
To be found: the specifics of the situation (the type of data, the potential consequences of disclosure for the patient, and other people).
  1. What are the values?
Patient: the right to privacy.
The party seeking information: in certain cases, the information can be crucial for the safety of other people. Thus, the right of other people to safety and even life might need to be taken into account.
  1. What are my options?
  • Using legal guidelines.
  • Using local policies.
  • Using personal judgment.
  • Using a combination of all the above-mentioned guidelines.
  1. What should I do?
A combination of guidelines is likely to be required to determine the specifics of the information to be disclosed.
  1. What justifies my choice?
  • The existence of gray areas (Rinehart-Thompson & Randolph, 2015).
  • The conflicting interests of the parties.
  1. How can I prevent this problem?
  • Must stay updated on relevant regulations.
  • Must maintain BH information policies.
  • Must seek legal advice if needed.

References

American Medical Association. (2001). Principles of medical ethics.

American Health Information Management Association. (2011). AHIMA Code of Ethics.

Hanken, M.A., & Murphy, G. (2015). Electronic health records. In L. Harman & F. Cornelius (Eds.), Ethical Health Informatics (pp. 317-346). Burlington, MA: Jones & Bartlett Learning.

Joy, M., Clement, T., & Sisti, D. (2016). The ethics of behavioral health information Technology. JAMA, 316(15), 1539.

Rinehart-Thompson, L.A., & Randolph, S. J. (2015). Substance abuse, behavioral health, and sexual information. In L. Harman & F. Cornelius (Eds.), Ethical Health Informatics (pp. 509-542). Burlington, MA: Jones & Bartlett Learning.

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