Hospital operating company Community Health, Inc. recently announced it was the target of a “highly sophisticated malware and technology attack” during the months of April and June. The attack is believed to have originated in China, ultimately affecting about 4.5 million people. The hacker was able to bypass the company’s security measures and copy data including “patient names, addresses, birth dates, telephone numbers, and social security numbers.” The information taken was described as being solely “non-medical,” Patient medical information, as well as credit card numbers were allegedly not compromised. The company has begun to notify patients of the breach and is offering identity theft protection to affected patients.
Soon, Congress will hear testimony concerning the Helping Families in Mental Health Crisis Act. Republican representative, Tim Murphy, from Pennsylvania, sponsored the bill, and, though many agree that the mental health care system requires revamping, some provisions in the bill have sparked controversy. Among the more controversial provisions is one that supports the increased use of involuntary outpatient treatment—via court-ordered therapy for “certain mentally ill people with a history of legal or other problems.” Detractors of this provision claim that it will erode trust in doctor-patient relationships, and that it presents a civil rights issue. However, 45 states have compelled treatment programs already, one of which is New York.
New York’s compelled treatment program, Kendra’s Law, was passed in 1999. Since the implementation of Kendra’s Law, studies show that the percentage of patients returning to the hospital or getting arrested has greatly decreased. The statistic is significant, as “about 350,000 Americans with a diagnosis of severe mental illness…are in state jails and prisons” and the availability of psychiatric beds meets only 10 percent of that need.
Anti-fetal homicide laws were enacted originally to protect mothers of unborn children against violent acts. Yet, in reality, “they’ve led to disproportionate prosecution against African American women who suffer miscarriages.” An ongoing case in Mississippi could set a dangerous precedent with regard to the criminalization of pregnant women for their purportedly reckless acts. Rennie Gibbs was charged with the murder of her unborn child after it was stillborn when she was 16 years old. Gibbs is being prosecuted for “depraved heart murder” because the autopsy showed that Gibbs had used cocaine during her pregnancy—but the cause of death was originally attributed to the umbilical cord being wrapped around the infant’s neck. That cause of death was never ruled out.
In 1990, Congress approved the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. The CARE Act funds support and medical treatment for individuals with HIV. However, under the Act every state had to certify that it had criminal laws that would prosecute individuals with HIV who knowingly exposed others to the disease, even if those exposed did not contract HIV. Individuals who are successfully prosecuted under these laws are listed as sex offenders. In one case in Iowa, a woman was prosecuted successfully even though she claimed that she informed the man that she was HIV positive. He claimed she did not tell him; however, two weeks prior to filing his complaint against her, he was convicted of domestic abuse for hitting her. She is now listed as a sex offender.
Currently, the federal government and advocates consider these HIV-specific laws to be draconian in light of modern scientific knowledge regarding HIV, which is “no longer the death sentence it once was.” Many of these HIV-specific laws do not require exposure in the form of sexual contact, and some even include exposure in the form of something as innocuous as spitting. HIV cannot be transmitted through saliva. Some states, including Iowa, are reconsidering and changing their HIV-specific laws in response to this change in public opinion.
The Joint Behavioral Health and Firearms Safety Task Force of Rhode Island approved a final report for submission to the General Assembly, which concerns how Rhode Island should submit mental-health records to the National Instant Criminal Background Check System (NICS). Ultimately, the Task Force recommends that Rhode Island submit only the names of patients committed involuntarily because a judge deemed them a danger to themselves or others. Sen. Frank Lombardi, D-Cranston, believes that the Task Force’s determination strikes the correct balance between: the right to privacy; public safety; and, “the recognition of mental health as an illness and not as a stigma.”
A Harvard Medical School study revealed that one in three Medicare patients with narcotic prescriptions received the prescriptions for the same drug from multiple doctors. The doctors of these patients did not know the patients were receiving the prescriptions from other doctors already. It is likely that this trend contributes to the rise in prescription narcotics, as well as to the deaths from patients overdosing unintentionally on these drugs. Another study, published in the British Medical Journal, revealed that 35% of 1.2 million Medicare patients who received prescriptions for opioids received prescriptions for the same drug from several doctors.
On September 27, 2013 the National Institute of Health (NIH) announced that it is seeking public comment on draft proposals regarding how researchers should share data from genomic research projects. The goals of the proposal are: to protect the privacy of participants in human subject research; to protect intellectual property rights; and to promote data-sharing in order to advance genomic research. Under the proposal researchers would be able to combine data from various projects, which would enhance the value of the scientific data collected. The public may submit comments to the NIH until November 20, 2013.
The Kaiser Family Foundation is conducting a long-term research project in California, in order to determine whether the Affordable Care Act (ACA) improves the uninsured population’s ability to obtain affordable health insurance. The Foundation selected 2,000 California citizens without health insurance. It will follow these citizens for two years as they navigate the insurance exchanges created by the ACA.
Read more about the study and the first wave of results here.
The National Institute of Health (NIH) will grant twenty-five million dollars, over the next five years, in order to examine health, privacy, economics, interpersonal issues and newborn genomic screening. The NIH will take DNA samples from newborns, from four U.S. cities; however, many of the parents and children involved will have no notice that their DNA is being studied.
The goal of the NIH is to discover whether it is economically feasible to obtain every newborn’s DNA for analysis purposes. Currently, newborns are screened for twenty-six manageable, or even preventable, conditions or diseases. The current screening costs approximately one-hundred dollars; however the new genomic screening costs approximately five-thousand dollars. In addition, some are concerned that, if genomic screening proves successful, many parents may limit their children’s activities in order to protect them from disorders that may never develop.
Recently, USA Today conducted an investigation in order to ascertain whether state medical boards are taking appropriate disciplinary measures for doctors guilty of “serious misconduct.” The findings are disturbing; for example, one finding shows that from 2001 to 2011, fifty-two percent of doctors who had their clinical privileges removed by a medical institution were not punished by a state medical board. Although hospitals and other healthcare related entities are required to report disciplinary actions involving doctors to the National Practitioner Databank, typically only a state medical board can affect a doctor’s actual license.
Despite the investigation’s findings, Lisa Robin, chief advocacy officer at the Federation of Medical Boards, maintains that state medical boards “‘take their responsibility very seriously in taking actions, being thoughtful, and … protecting the public.’” Taking disciplinary action can be an intricate pursuit for state medical boards, often involving complex legal issues such as due process and patient confidentiality. To further complicate matters, many state medical boards are operating under strict budgetary constraints.