Health care privacy laws important, but can hinder clergy-patient relationship

www.bethyam.orgMarch 14, 2014 

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Laws meant to protect patients' privacy can get in the way of their in-hospital spiritual care.

LAMBERTO ALVAREZ — McClatchy-Tribune News Service

We are living in the age of privacy, in which we want to protect information about ourselves so we can have full control of our lives.

The notion of privacy strikes deep into our psyche and our sense of psychological safety, as well as our pocketbooks. We have passwords -- oh so many passwords -- that protect our computers, bank accounts, financial investments and even our children's grades in college. And we have more and more laws that protect us from personal intrusion, something that is generally accepted to be a good thing.

Our health care privacy laws, though, are an example of the kind of government regulation I'd expect to receive backlash. Yet I am not hearing much complaint.

For me, this particular issue of privacy has spiritual repercussions when, due to laws that protect patient confidentiality, the proper spiritual care might be at risk. These rules threaten to further distance the patient from his or her spiritual community, which might play a critical role in their ability to cope with and face the challenges of surgery and life and death decisions.

The federal laws I am referring to are commonly called HIPAA, or Health Insurance Portability and Accountability. They were enacted in 1996 and went into effect in 2003. The purpose was to allow consumers the ability to have access to and manage their medical information in an effort to prevent misuse. The laws were intended to restore a much-needed trust in the health care system and create a national standard to protect the privacy of health care information.

When it comes to providing pastoral care, the HIPAA laws have created challenges for clergy, patients and families in a hospital setting.

Community clergy are severely limited regarding what they need to know in order to provide religious support and pastoral care. Of course, chaplains, depending on the policies of the hospital, do not have an ongoing relationship with the patient outside of their hospitalization; yet, they may have access to more information than the visiting clergy.

Another issue is finding out who is in the hospital. In some hospitals within our own region the regular admission process may offer the patient the choice to identify a religion upon registration. The problem is that when a patient enters through the emergency room the intake process does not necessarily follow through with attempting to provide the patient the opportunity to have access to their clergy.

Timing is always critical for clergy to be with their congregants. All of this has a direct impact upon congregations that promote hospital visitation committees from their own members as part and parcel of their faith tradition.

Clergy and volunteer leaders should educate our respective communities that they must identify to hospital authorities as early as possible that they would like a visit from their clergy.

Hospitals could do a better job at working cooperatively with and educating local clergy. I would like to see a registry of community clergy so as to effectively enable them to have access within the boundaries of the HIPAA laws.

The chaplain, who plays an important role, should do whatever possible to help facilitate communication or at least notification on behalf of the patient to their clergy. The hospital should have ongoing seminars for community clergy to educate them about privacy laws. In addition the hospital could do more to work with visitation groups from houses of worship to educate them when they come to visit.

Hospitals should strive to be collaborative. Let's not forget that the hospital is a multidisciplinary institution. It can look sedate, but the truth is that patients can feel the intensity of pressure in coping with their medical condition. They can experience a spectrum of emotions, such as isolation, fear and depression. Many feel comforted by the prayer of their congregation's clergy, who gives them hope and spiritual support.

Most hospitals that are small -- like our local ones -- may have only one full- or part-time chaplain on duty. Yes, there are hospital volunteers who do yeoman's work as well. At the same time, patients might want to speak with a clergyperson of their own faith tradition, even if they are not actively involved in that religion.

Hospitals can do better at breaking down administrative barriers, even if they are unintended ones as a result of the HIPAA laws.

Privacy for patient records is undeniably critical and an important safeguard. But the age of privacy requires all of us -- the patient, family, clergy and the hospital -- to work together, because healing comes in many different ways for the human being. The spiritual, medical and psychological overlap each other in treating the patient and returning them to their lives once their stay in the hospital is over.

Columnist Rabbi Brad L. Bloom is the rabbi at Congregation Beth Yam on Hilton Head Island. He can be reached at 843-689-2178. Read his blog at www.fusion613.blogspot.com and follow him at twitter.com/rabbibloom.

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