The need to know versus the right to know: privacy of patient medical data in an information-based society

"Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret."(1) "Safeguards to privacy in individual health care information are imperative to preserve the health care delivery relationship and the integrity of the patient record."(2) As early as the fourth and fifth centuries B.C., Hippocrates contemplated the importance of medical information to the care and treatment of patients. His oath suggests that privacy of a patient's medical information creates the foundation upon which a patient reposes trust in his or her physician. While defining the earliest version of the physician-patient privilege, the oath does not envision the extent of modern day access to healthcare information. A patient's relationship with the modern healthcare delivery system often includes a team of physicians, nurses, and other clinical support personnel. This relationship extends beyond direct caregivers and may include healthcare administrators, payor organizations, and persons unfamiliar with a patient's identity, such as researchers and public health officials. Accessing a patient's medical information links these participants to the patient's healthcare delivery relationship. The Hippocratic Oath does not contemplate such broad access, nor does it contemplate the emerging privacy crisis resulting from the application of computer technology to medical record storage and retrieval. The combination of broad access, individual privacy rights, and computer technology requires a rethinking of measures designed to protect the realities of the modern medical information society.     

The Cairo Stories: Some Reflections on Conflict Resolution in Egypt

The author relates three cases of conflict which he has observed in Cairo and recognizes patterns that cut across each of these stories. The stories shed light on how people in Egypt approach and deal with conflict; in addition, they may help readers understand conflict in their home culture as well as be instructive on how to listen to conflict in different cultures. Six general themes in the way Egyptians approach or handle conflict are identified, and each of these themes is analyzed.     

Explaining “Pain and Suffering” Awards: The Role of Injury Characteristics and Fault Attributions

The present research explored factors thought to affect compensatory awards for non-economic ham (pain and suffering) in personal injury cases. Experiment 1 showed that the nature and severity of the plaintiffs injury had a strong effect on perceptions of the extent of harm suffered and on award amounts. The parties' relatively active or passive roles in causing the injury affected assessments of their degree of fault, but perceived fault had little influence on awards. Experiment 2 replicated with more varied cases the strong impact of injury severity on harm perception and on awards for pain and suffering. In both studies, the disability and the mental suffering associated with injuries were stronger predictors of awards than were pain and disfigurement.     

The State of American Federalism, 1996-1997

Federalism enjoyed political and popular salience during theperiod 1996–1997 as the so-called "Devolution Revolution"began to be implemented and analyzed in the United States. Whilethere were a few examples of important Revolutionary efforts,the federal government continued to hold much of the power andsignificance it has achieved over the past sixty years. Evenin the area of welfare policy, where in 1996 there were historicreforms enacted to end the federal entitlement, the federalgovernment maintained a significant presence that made the ideaof devolution of welfare policy responsibility some what questionable.Nevertheless, states continued to lead in policy innovationin areas ranging from education to health, and the U.S. SupremeCourt continued to question the limits of federal power. Thepast year illustrated, once again, the complexity of our federalsystem and how difficult it is to reform federalism—particularlywhen it involves a shift in power and creates the perceptionof winners and losers.     

Candidate Character vs. The Economy in the 1992 Election

The outcome of the 1992 U.S. presidential election has been explained largely as a function of perceptions of George Bush's economic performance. The economy submerged questions about Bill Clinton's character, awarding the advantage to the Democrat. In this article, we evaluate the effect of economic evaluations along with character attacks on candidate support in the 1992 presidential contest. Claims that the economy submerged character have been somewhat exaggerated. But while character remains an important issue in presidential evaluation, its role in judging candidates cannot be taken at face value. We show that both economic evaluations and character judgments are highly politicized. The findings indicate that those protesting Clinton's character turned almost exclusively to Bush. Those protesting Bush's economic record turned to both Perot and Clinton. Still, the economy did not trump character. The troubles of both major party candidates fueled a strong protest vote that contributed to Perot's strong showing.