Hematology/oncology clinics of North America
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Hematol. Oncol. Clin. North Am. · Dec 2002
ReviewMedical information, confidentiality, and privacy.
State laws and accreditation requirements dictate the form, ownership, and substance of medical records, as well as requirements for storage, access, and confidentiality. There are limited exceptions to these requirements but they are highly circumscribed. Federal law also outlines requirements to ensure the privacy of patient-identifiable information. Thus, providers must be aware of these rules both to protect patient information from being abused and to understand the affirmative obligations they have so as to avoid the significant penalties associated with breach of these provisions.
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Understanding the legal definition of whole-brain death is imperative for hematologists and oncologists who deal with end-of-life patients on a regular basis. At present, only whole-brain death in which there is no function of the upper brain or brain stem is legally recognized as legal death. ⋯ Those advocating a more narrow definition of death typically fear being misdiagnosed or prefer the traditional cardiopulmonary definition for personal and religious reasons. As medical technology advances, offering new hope to both the critically injured patients who might be potential donors and to those patients in need of donated organs, the definition of death will continue to be a topic of passionate debate.
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Hematol. Oncol. Clin. North Am. · Dec 2002
ReviewAdvance directives and life-sustaining treatment: a legal primer.
Advanced directives are a natural extension of a patient's right to self-determination of what actions will be taken upon his or her body. As such, instructional advanced directives such as living wills and DNR orders represent important patient preferences that must be adhered to in the health care context. ⋯ Overall, advanced directives provide health care providers, patients, and patient families with control over the kinds of care they do and do not desire at the end of life. Understanding the legal status of these instruments will provide the physician with another tool to advocate effectively for the patient.