Snap Judgment

Anyone who is a member of AHIMA or holds its credentials agrees to abide by its code of ethics.

The code sets forth professional values and ethical principles, and it offers guidelines to which professionals aspire. “Ethical behaviors result from a personal commitment to engage in ethical practice,” it notes.

A code of ethics also offers a guide by which individual decisions and actions can be judged.

A case in point is the scenario below, written by AHIMA’s Professional Ethics Committee. Is there a concern with the actions described, and if so, what would be an appropriate response?

Scenario

A 20-year veteran of the HIM department started her career as a night-shift file clerk when an innovative tertiary care center built a sister facility in her community. She has been a long-time fan of her facility, and her friends and family have heard remarkable stories about her experiences, promotions within the department, and even some notable patients. She has now been promoted to supervisor over EHR coordinators and is clearly proud of this accomplishment.

During a lunch break, she literally bumps into a long-time benefactor of the facility who is also a well-known talent icon. The benefactor has been a patient in the facility in the past. She is so excited that she takes his photograph with her cell phone. She shares the photos with her coworkers. The next day, she posts the photos on Facebook. Her director is contacted by the CEO. Is this an ethical violation?

Discussion

There is definitely a concern. While this act may not have been malicious, the results may have inadvertently caused harm.

The first principle of AHIMA’s Code of Ethics has been abused, but not necessarily violated: “Advocate, uphold, and defend the individual’s right to privacy and the doctrine of confidentiality in the use and disclosure of information.”

Each individual organization will shape policies, practices, and procedures that are consistent with its culture. For some organizations, this will result in zero tolerance for this activity because the employee is in a position in which she should have known better. Other organizations may decide that since this is an excellent employee with a stellar history, the situation calls for education and training.

Tell us what you think. How would you or your organization handle such a scenario?

If you would like to take a measure of your own professional ethics, AHIMA offers an ethics self-assessment. There is no scoring mechanism, but the answers are useful in identifying strengths and suggesting areas that may need review.

4 Comments

  1. Unfortunately, this 20 year veteran went off the rails when she “shared” with others about
    notable patients, long before she snapped the photo! Also, discussing promotions (besides hers) and other department, hospital business is unprofessional and also can easily slide into the area of the unethical.
    Of course this wasn’t malicious…doesn’t matter…this woman is one big HIPPA violation waiting to happen.
    Our hospital reminds employees yearly through an on line learning situation what is included in “confidentiality”….

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  2. This is a confusing scenario. If she literally bumped into him and ended up taking his picture, does that mean he posed for the picture? Or did she take his picture without his knowledge? If he posed for the picture, I’m having trouble seeing the problem with this.

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  3. The person was identified as a “long-time benefactor of the facility,” not a patient, so I don’t see patient confidentiality applying. However, looking at the issue from a photographer’s standpoint and a ‘political’ standpoint, will reveal she should not have done this. Regardless of whether it was legal or not, a violation of hospital policies or not.

    First, it doesn’t say where she took the picture so we don’t know whether she should have asked for a Release before posting it publicly. If she shot it at a private event, where there was an expectation of privacy, she should have gotten a release (there are exceptions but to be safe, yes). If she shot it in public, on the street, where theoretically anyone in the world could have seen him – a release is not necessary.

    If it was her own personal noncommercial facebook page, it would have been a noncommercial use. So if she shot it in public, no release, and he sued her nonetheless, he’d probably lose.

    However, why do we want to go here? Why do we even want to take a chance of even developing such scenarios? How is it worth it?

    The other issue is subjective. Nearly everyone has a picture of themselves that everyone loves, thinks is a great, flattering picture – but you,yourself, hate the picture. You wish you could take it out of the yearbook, off your driver’s license or whatever. You often do not know when you shoot an image whether you’ve just shot one of these doozies.

    So then, suppose you post one of these doozies, without showing it to the person, without getting their opinion of it, without asking whether they’d mind if you post it on your facebook page. What is going to happen? You’re going to have annoyed the person, to say the least.

    Do you want to take the chance on annoying or angering one of your facility’s benefactors? Just to impress a few facebook friends? Not worth it.

    Further, YOU may know that the circumstances don’t violate copyright law, nor HIPAA, nor hospital policy. But does the benefactor? These words could be going through his head: “She not only took a terrible picture of me, but she violated copyright law, she violated HIPAA, and she violated her own hospital’s policies and posted it on the internet for the whole world to see! I don’t want to deal with her at all in the future.” Does it matter at that point who’s legally or technically right and who’s wrong?

    I don’t think so.

    Not the thing to do. She should not have done that.

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  4. I just now learning, my first year back in 03-06, we had to take the HIPAA law, before going to our clinicals, when I got that picture it surely be unethical. I don’t know what makes for her different, HIM HIA, whatever, we have a standard, fresh from graduation from a 2 year or PHD, or benefactor, she should already have known this, unless there is something else going on. That would piss me off, for HIM graduate from accredrentating college. Wouldn’t you?

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