平衡患者护理与保密性：获取旁证信息时的考量

Balancing patient care and confidentiality: considerations in obtaining collateral information.

作者信息

Petrik Megan L, Billera Melodi, Kaplan Yuliya, Matarazzo Bridget, Wortzel Hal

机构信息

PETRIK: Psychology Postdoctoral Fellow at the Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, and Instructor in the Department of Psychiatry, University of Colorado, Aurora, CO BILLERA: Clinical/Research Social Worker at the Rocky Mountain MIRECC, Denver VA, and Adjunct Professor at the University of Denver Graduate School of Social Work, Denver KAPLAN: Clinical Research Assistant at the Rocky Mountain MIRECC, Denver VA Medical Center, Denver MATARAZZO: Co-Director of the Rocky Mountain MIRECC Suicide Consultation Service, Rocky Mountain MIRECC, Denver VA, and Assistant Professor of Psychiatry, University of Colorado, Aurora WORTZEL: Michael K. Cooper Professor of Neurocognitive Disease, Director of Neuropsychiatry, an Associate Professor in Psychiatry, Neurology, and Physical Medicine and Rehabilitation, and Faculty for the Forensic Psychiatry Fellowship at the University of Colorado, Aurora. He is Director of Neuropsychiatric Services for the Rocky Mountain MIRECC at the Denver VA, Denver, CO.

出版信息

J Psychiatr Pract. 2015 May;21(3):220-4. doi: 10.1097/PRA.0000000000000072.

DOI:10.1097/PRA.0000000000000072

PMID:25955265

Abstract

Collateral information facilitates comprehensive mental health care and is consistent with recovery-oriented models of care. But providers are often faced with complex decisions about obtaining collateral information, particularly when patients do not consent to communication with third parties for information gathering. Such situations require a thoughtful balance of best clinical practices, legal and ethical responsibilities, and patient safety concerns. This column offers an overview of the clinical utility of collateral information as well as the ethical and legal regulations concerning confidentiality that guide the process of obtaining collateral information. The risk-benefit analysis process related to obtaining collateral information without patient permission is illustrated. Recommendations about clinical consultation and documentation that facilitate optimal and ethical patient care are offered.

摘要

旁系信息有助于提供全面的心理健康护理，并且与以康复为导向的护理模式相一致。但医疗服务提供者在获取旁系信息时往往面临复杂的决策，尤其是当患者不同意与第三方沟通以收集信息时。这种情况需要在最佳临床实践、法律和道德责任以及患者安全问题之间进行审慎权衡。本专栏概述了旁系信息的临床效用以及指导获取旁系信息过程的保密方面的伦理和法律法规。阐述了在未经患者许可的情况下获取旁系信息的风险效益分析过程。还提供了有关临床咨询和记录的建议，以促进提供最佳且符合伦理的患者护理。