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PATIENT CONFIDENTIALITY AND THE CRIMINAL JUSTICE SYSTEM - A CRITICAL EXAMINATION OF THE NEW FEDERAL CONFIDENTIALITY REGULATIONS

NCJ Number
46879
Journal
Contemporary Drug Problems Volume: 5 Issue: 4 Dated: (WINTER 1976) Pages: 531-552
Author(s)
J C WEISSMAN; B R BERNS
Date Published
1977
Length
21 pages
Annotation
A CRITICAL REVIEW OF THE 1975 SUPPLEMENT TO THE CODE OF FEDERAL REGULATIONS REGARDING PROTECTION OF THE CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS IS PRESENTED.
Abstract
THE SCOPE OF THESE REGULATIONS IS COMPREHENSIVE; PATIENT RECORDS ARE BROADLY DEFINED, AND THE REGULATIONS APPLY TO THOSE INVOLVED IN THE DELIVERY OF ALCOHOL AND DRUG ABUSE SERVICES AND TO ACTIVITIES RELATED TO JUSTICE ADMINISTRATION. IN PART, THESE REGULATIONS REFLECT THE HISTORICAL CONFLICT BETWEEN THE TREATMENT AND THE CRIMINAL JUSTICE SYSTEMS, AND THE AMBIVALENCE OF THE CRIME/ILLNESS VIEW OF SUBSTANCES ABUSE. THIS AMBIVALENCE IS REFLECTED IN DRUG AND ALCOHOL OFFENSE LAWS AND THE ATTITUDES OF JURISDICTIONS, JUDGES, AND LAW ENFORCEMENT PERSONNEL. THIS AMBIVALENCE HAS AN ENORMOUS IMPACT UPON THE ROLE PERCEPTIONS AND PERFORMANCE RESPONSIBILITIES OF THE PROBATION OFFICERS AND THE TREATMENT PROFESSIONALS WHO ARE FACED WITH THE CONTRADICTORY DEMANDS OF BEING BOTH TREATMENT AND SURVEILLANCE/PUNISHMENT AGENTS. THE MODIFIED CONFIDENTIALITY REGULATIONS EXCEED THE SCOPE OF THE TRADITIONAL PATIENT/PHYSICIAN PRIVILEGE BY IMPOSING A LEGAL DUTY UPON PHYSICIANS AND THEIR AGENTS TO GUARD THE CONFIDENTIALITY OF PATIENTS' RECORDS. THE REGULATIONS APPLY TO RECORDS OF THE IDENTITY, DIAGNOSIS, AND TREATMENT MAINTAINED IN CONNECTION WITH THE PERFORMANCE OF ANY SUBSTANCE ABUSE PREVENTION FUNCTION. THUS, THE REGULATIONS REQUIRE, UNDER PENALTY OF FINE, THE PROTECTION OF ANY AND ALL INFORMATION COLLECTED IN RELATION TO TREATMENT EVEN WHEN THE PREVENTION OR TREATMENT ACTIVITY IS CONDUCTED BY A CRIMINAL JUSTICE AGENCY. SPECIFIC PROVISIONS THE CONFIDENTIALITY REGULATIONS RELATING TO THE CRIMINAL JUSTICE/SUBSTANCE ABUSE INTERACTION ARE OUTLINED AND THEIR INTENT AND IMPLEMENTATION POTENTIAL ARE DISCUSSED. THESE PROVISION RELATE TO CRIMINAL JUSTICE REFERRALS MADE AS A FORMAL CONDITION OF RELEASE FROM CONFINEMENT; DISPOSITION OF CRIMINAL PROCEEDINGS, OR THE EXECUTION OR SUSPENSION OF AN ALREADY IMPOSED SENTENCE; THE COMMISSION OF CRIMES BY PATIENTS; THE EMPLOYMENT OR ENROLLMENT OF INFORMANTS OR UNDERCOVER AGENTS IN SUBSTANCE ABUSE TREATMENT PROGRAMS; AND CRITERIA AND PROCEDURES FOR IMPLEMENTATION OF A COURT ORDER PERMITTING DISCLOSURE IN LIMITED CASES. IT IS SUGGESTED THAT COMPLIANCE WITH THE REGULATIONS WILL BE DEPENDENT UPON THE FAMILIARITY AND PHILOSOPHICAL AGREEMENT OF AFFECTED AGENCIES WITH THE NEW REGULATIONS. UNDERENFORCEMENT IS PREDICTED. (JAP)