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Doctors Outraged At Patriot Act's Potential To Seize Medical RecordsAuthor(s): Jeanne LenzerSource: BMJ: British Medical Journal, Vol. 332, No. 7533 (Jan. 14, 2006), p. 69Published by: BMJ Publishing GroupStable URL: http://www.jstor.org/stable/25455841

Accessed: 10/10/2010 05:40

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News

Doctorsoutraged

at Patriot Act's

potential to seize medical records

Jeanne Lenzer New York

US doctors across thepolitical

spectrumare

protestingat a

pro

vision in the Patriot Act that

allows the government to seize

patients' medical records without

aprobable

cause or a warrant.

The actprohibits doctors from

telling anyone, includingthe

patient,that their sensitive medi

cal records have been seized.

Doctors who violate thegagging

order can be fined and prosecut

ed for obstruction ofjustice.

The Association of American

Physicians and Surgeons (a lib

ertarian group based in Tucson,

Arizona) and the American Civil

Liberties Union, which has many

doctor members, havejoined

in

a coalition, called Patriots to

Restore Checks and Balances, to

urge Congressto amend Section

215 of the act. Theprovision,

whichonly recen?y

came to

light,allows the Federal Bureau

ofInvestigation (FBI) to

geta

secret court order to seize"any

tangible things," includingmedi

cal records, student or work

records, and evenlibrary

records. Coalition members say

that medical records areunlikely

toprovide useful information

about terrorists.

The act, passedin the wake of

the 11 September 2001 terrorist

attacks, gives the governmenta

broad range ofrights

to monitor

US citizens and is set toexpire

on

3February. President Bush is urg

ing Congressto renew the act He

said, "We're still under threat,

there's still anenemy that wants to

harm us, andthey

understand the

Patriot Act is animportant tool

for those of us here in the execu

tive branch to use toprotect

our

fellow citizens."

The inclusion of medical

records washighlighted by

a

reporter, Joy Buchanan from the

DailyPress in

Newport News, Vir

ginia, who was alerted to a clause

in one medical centres' brochure

for patients on privacy.

The brochure stated that the

centre"may

disclose medical

information about you to auth

orised federal officiais sothey

may without limitation (i)provide

protectionto the President, other

authorised personsor

foreignheads of state or conduct

special

investigations,or (ii) conduct law

fulintelligence, counter-intelli

gence,or other national

security

activities authorisedby

law."

Ms Buchananreported

the

story in theDaily

Press on 29

December (sect A: 1).

Subsequent investigations

have shown thatvirtually

all

medical centres haveincorporat

ed the same or similarlanguage

in their brochures. Under the

Health InsurancePortability and

Accounting Act, patientsmust

be told that their records arepri

vate and about any exceptionsto

that rule. The statements are

Housejudiciary chairman, James Sensenbrenner (centre), at a news

conference on the Patriot Act with homeland security committee

chairman PeterKing (left) and the

attorney general,Alberto Gonzales

often asingle paragraph

in

documents several pages long,which are

givento

patients

beforethey

see a doctor.

Michael Williams, associate

professor ofneurology

and neu

rosurgery atJohns Hopkins Uni

versity, Baltimore, said most

peoplein the United States don't

seem to know about Section 215.

"Ionly

found out about it in

June 2005 at ameeting

of the

American Medical Association.

Ifpatients

knew about this, I

thinkthey

would be bothered?

or Ihope they would be," he

said. "If our records can be

seized with nosafeguards then

we're all in trouble."

DuaneCady, chairman of the

board of the American Medical

Association, said that the associa

tionadopted

a newpolicy

inJune

2005"calling

for modifications to

the Patriot Act toprotect patient

confidentialityand minimise

legal

liabilityfor

physicians."

Congressman DanLungren

of California defended the pro

visionallowing

the seizure of

medical records. He said itmight

beimportant

to know if, for

example,someone connected to

an international terroristorgani

sation soughtan anthrax vac

cine. He said the government

couldn't afford to be limitedby

the need for"probable

cause."

There is an "essential differ

ence," he said, "between a crimi

nalinvestigation

toprove who

committed a crime after it's

occurred and the need to pre

vent terrorist attacks."

Jane Orient, executive direc

tor of the Association of Ameri

canPhysicians

andSurgeons,

warned, "This waragainst

terror

ism is atotally open ended affair,

and the definition of terrorism is

[overly] broad." D

Seewww.aclu.org/privacy/

medical/ 15222res20030530.html.

UK drug companies must disclose

funding of patients' groupsMichael

DayLondon

Drug companiesmust make

publictheir involvement with

patients' advocacy groups, under

a revisedindustry

code of prac

tice introduced in the United

Kingdom this month.

From 1January firms are

expectedto name all

patients'

organisations that receive their

financialsupport. They

must

also set out details of such rela

tionshipsand any funding pro

vided, say the new rules of the

Association of the British Phar

maceuticalIndustry. The

update

of the code wasprompted partly

bythe severe criticism the indus

try received in theparliamentary

health select committee's reporton the influence of

drug compa

nies, publishedin

Aprillast year.

Aspokesman

for the associa

tion said: "This isdesigned

to

ensure that the industry's

involvement withpatient groups

iscompletely transparent. It's

now up to thevoluntary

sector

to do theirpart."

Charles Medawar, who runs

thecampaign group Social

Audit, said, "Links with patient

groupsare now considered such

amajor marketing

tool and such

anintegral way of

competing

with thecompetition,

I doubt the

industrywill

voluntarilyalter

thingstoo much."

However, Harry Cayton, the

government's national director

for patients and thepublic, wel

comed the revised code of prac

tice?and he also called on

patients' organisationsto show a

similar level oftransparency.

He said, "I welcome this

move?and I would urge

patients' groups to beequally

as

upfront.The charitable sector

does need to raise itsgame."

MrCayton

said thatduring

his time as chief executive of the

Alzheimer'sSociety

the group

received a small amount of itsincome ("less than 0.1 per cent")

from thedrug industry but that

itwas declared.

Simon Williams, director of

policyat the Patients Associa

tion, said: "Some groups simply

couldn't survive without money

from thepharmaceutical indus

try, buttransparency is

vitally

important and notonly

in terms

ofdrug company funding.

If a

group gets money from another

source, say the government, that

should be declared too. We

make it clear on our publications

and annualreports of any fund

ingwe receive." D

Key changesto the code are listed

atwww.abpi.org.uk/press/

press_releases_05/051116b.asp.

BMJ VOLUME 332 14JANUARY 2006 bmj.com 69