Young mans brain kept after autopsy.

[Skeptic Ginger]

I find her as frustrating as you sometimes. I think you've made your point that this information is not "confidential" in the medical legal sense, but it's also true that it should be considered sensitive. It is careless for morgue workers to have left these specimins out where people who knew the deceased would have found them.

Translation: either you didn't look at what I posted, or you are having trouble with reading comprehension today.

 

[Uncayimmy]

I'm skeptical that you are interested in anything but pissing contests.

Please don't make this personal. Either defend your claims or don't. My motivation is irrelevant.

If you are interested in actually learning about medical confidentiality, your first mistake is believing it has something to do with some legal technicality. It doesn't. It has to do with ethical patient care.

You can start here: AMA's paper on patient confidentiality.

It's like medical practice, there is judgement involved. If I diagnose your STD and you tell me you don't want your wife to know, I am obligated ethically to tell your wife. You cannot sue me for telling her.


The parents in the OP case can easily show in court that allowing high school students to see confidential information in the morgue caused the parent of the deceased teen serious distress. The defense will likely argue the students were not just casual observers but were in a legitimate class with the morgue as a clinical. The morgue could argue the school had a duty to assure the students understood confidentiality and the breach occurred when the students told the parents of the deceased about seeing their son's brain. But since the students were likely under 18, they would not be financially liable. And if that meant their parents were, you can imagine the parents of the students would be countersuing the morgue and the school that the kids were traumatized by seeing their friend's brain in the morgue.

The morgue would be wise to settle any lawsuits here out of court if an apology was not enough to satisfy the distressed parties. It's highly unlikely the morgue would win their case in court based on some claim that the death of the friend was public knowledge.

A breach in medical confidentiality is not dependent upon some specific legal wording, it is about professional conduct and misconduct.

The reason I bolded the bit about the irrelevant medium is the labeled brain jar would be an unusual medium, but that wouldn't mean it wasn't an ethical breach.

You still haven't answered the very basic question: What confidential information was revealed? I have not once argued that confidential information can be disclosed, so it's pointless to simply tell me what I already know and accept.

Look, in many states autopsy reports are public records, and this has been affirmed by the courts. Autopsy reports can reveal quite a bit of information. In this case as far as I can tell the only thing revealed was, "This kid's brain is in a jar at the morgue." As best as I can tell even in states with closed autopsy reports the fact that a body is undergoing an autopsy is a matter of public record. That's not confidential information.

You made a bold assertion of a "serious breech [sic] of confidentiality," and I'm simply asking you to support that assertion. Perhaps you are aware of information that I am not.

 

[Uncayimmy]

I find her as frustrating as you sometimes. I think you've made your point that this information is not "confidential" in the medical legal sense, but it's also true that it should be considered sensitive. It is careless for morgue workers to have left these specimins out where people who knew the deceased would have found them.

It wasn't careless according to the court that ruled on the case.

Here's the thing: The medical profession has an obligation to keep confidential information private. That doesn't mean all information. I touched on this when I first asked her the question. When you visit your doctor, other people see you in the waiting room. The nurse will usually call out your name. Therefore, the fact that you visited the doctor is not confidential information. As you navigate around the office, you may see someone going into an x-ray room or a room where blood is drawn. That means you may know a little something about the type of care "Mr. Clark" is receiving.

Is that a breach of confidentiality? Of course not. It's simply not reasonable for people to expect 100% confidentiality because it would place an undue burden on the medical profession. In this case we have a morgue doing its duties and keeping a labeled jar in a cabinet. In their duties educating the public someone catches a glimpse of the name on the jar. Most likely the fact that this person was getting an autopsy is a matter of public record. It's not confidential.

We can come up with all sorts of scenarios where confidentiality is expected, but that doesn't make any difference as to whether it was expected and required under these circumstances. I'm willing to listen to an explanation as to why it's a "serious" breach in this case, but so far, nada.

 

[dtugg]

I am also having trouble understanding how a brain in a jar is a breach of confidentiality.

 

[bluesjnr]

Me too! It all falls apart when you look at this in isolation.

A breach of confidentiality is a disclosure to a third party, without patient consent or court order, of private information that the physician has learned within the patient-physician relationship. ... The medium is irrelevant, although special security requirements may apply to the electronic transfer of information.

Given that the "patient" was dead they are unable to consent or otherwise. Dead bodies have few (if any) rights.

As I read it the students already knew that the guy was dead so it's hardly news that could be termed "private information".

 

[Skeptic Ginger]

No it is not. As students of a high school's forensics club, they were brought in to learn about the medical examiners office. Before doing so, they are required to sign HIPAA confidentiality forms. Which clearly these students violated by telling one of their parents and the sister of the deceased.

Now how would I know this? Well, because as an EMT you are required to ride on an ambulance for 8 hours and to observe and interact with patients in the ER for another 8 hours while in the certification program. I got an added bonus of being able to observe an autopsy conducted by the NYC OCME. Even before I could start any of my clinical rotations I had to sign 3 different HIPAA confidentiality forms stating that I would not release the names or information about the patients/victims I may come in contact with.

What the city did was in their legal rights and that was even determined in the lawsuit against them.

I addressed this but more can be said about it. You don't know if the school did any proper teaching about confidentiality here. Nor do you know if they did have the students sign anything about their obligation to maintain confidentiality. One would hope they did.

But high school program administrators and the morgue could still have been liable if the attorneys for the parents of the deceased argued it was not reasonable to expect the kids to act as a professional adult would under these circumstances. However, the attorneys for the deceased kid's parents did not make that argument. They argued the morgue had the brain on public display and the court found that was not the case.

The NY Supreme Court ruling:

Finally, we note that while the sole remaining cause of action in the complaint additionally alleges that Jesse's brain was mishandled by being placed on public display by the medical examiner, the defendants submitted evidence clearly demonstrating that the organ was simply kept in a cabinet with other specimens awaiting further examination and was never publicly displayed in the manner alleged. Since the plaintiffs failed to raise a triable issue of fact in opposition to the defendants' prima facie showing in this regard, the plaintiffs are precluded from pursuing this theory of liability at trial.

So the parents' of the deceased argued the jar was on public display, and they didn't show that occurred. No one would expect the parents of the deceased to sue the students for breaching confidentiality by telling people what they saw in the morgue. However, that doesn't mean there would not have been a case that the students did breach confidentiality for telling what they saw in the morgue. Just because no one pursued this in court doesn't mean it did not occur. It depends on what the attorneys argue.

And it doesn't mean it was professional and/or ethical or that everyone would agree with the court.
CNN

Dr. Cyril H. Wecht, a forensic pathologist and attorney who reviews cases like these but is not involved in the Shipley case, says the medical examiner was right to take out the brain for investigation but was wrong to openly display Shipley's name on it.
"You're talking about a matter of sensitivity and common sense," Wecht says. "Certainly if you're going to have student visitors, then you should not have names and numbers available to see."

It's hard to argue it would not be traumatic for kids to see their friend's brain in a jar in a morgue, forensics class/club or not.

AOL News

"There was a case that you could see through, and there were brains in jars and names on the jars. One said 'head trauma, Shipley, J,'" one of the students, Samantha Feldman, told the New York Daily News. She said Shipley's girlfriend and her best friend were in the group, and spotted the ghastly name tag.

"The best friend went outside and was flipping out," Feldman was quoted as saying. "She started crying and called her mom and said, 'Mom, Jesse's brain is here! I can't be here.'"

Later that day, the students returned to class and the school was abuzz with gossip about what they'd seen. Shipley's 14-year-old sister Shannon, who was a passenger and survived the same car crash that killed him, was at school and heard about her brother's brain in a jar.

"She fell apart," Ben-Aron told the Post. She was "hysterical," and school administrators had to call her parents to bring her home from school early, he said. "It was definitely very traumatic for the parents and for Shannon."

The students who saw the jar didn't sue the morgue or the school so we don't know what the court would have said about other aspects of the case.

Source? I checked your link and the link in the OP and couldn't find this.

Most of the news reports mentioned the morgue felt keeping the brain was reasonable. I can't find the news report where I thought I read the ME was sorry about the circumstances here. I may have skimmed the following from the CNN article about being sorry and misread who was sorry about what.

"I feel bad for those people who found out in the past and even worse for those who never will," Andre Shipley says. "We buried our son, and then two months after we had chunks of him coming back to us. This is not the way it's supposed to be."

Do you really think the ME was not sorry about the students seeing their friend's brain? He'd have to be one cold dude.

The point of that post was only that this was too well documented to be an urban myth which is what the post said that I was replying to.

 

[Skeptic Ginger]

I am also having trouble understanding how a brain in a jar is a breach of confidentiality.

Who said having the brain in the jar was the breach?

Students in a legit forensics class can see names on brains in a jar in a morgue. Given that, then the students breached the deceased's confidentiality when they told their friends what they saw in the morgue.

Or, you could have the opinion, as I do, that expecting high school students to keep their mouths shut about what they saw in the morgue is unreasonable and the adults involved (the school and the ME) should have anticipated the kids could not keep things they saw in the morgue confidential.

As for the things one sees in a morgue that have names attached being confidential, that is a professional ethical standard as well as subject to a number of legal regulations as well.

Morgue Services

All records and data must be kept secure and confidential because they are protected by the Health Insurance Portability and Accountability Act (HIPAA) of 1996, Public Law 104-191, and additional applicable local laws. ...

It is the responsibility of the Examination Group to maintain strict confidentiality of all documentation.

All Morgue Operations Staff

Prior to the commencement of examination and at the beginning of each shift a briefing will be conducted. The briefing will include but not be limited to:
§ Orientation and/or updates.
§ Safety procedures.
§ Necessity for security and confidentiality of all records and data.

An Introduction to Forensic Imaging

Legal and Ethical Considerations
All medical imaging personnel should be thoroughly familiar with the Health Information Portability and Accountability Act (HIPAA). This act ensures that all patient information is held in strictest confidence, and anyone found to be in violation of HIPAA may be subject to severe disciplinary actions. The same degree of confidentiality applies to anyone involved in imaging in a morgue facility. Forensic cases should always be regarded as sub judice. In law, sub judice, which is Latin for "under judgment," means that a particular case or matter is currently under trial or being considered by a judge or court, and should never be discussed with any person not directly involved in the case until the inquest or investigation has been completed. If the case is being considered by a court of law, the principles of confidentiality will be applicable throughout the proceedings. The radiographer should abide by the American Registry of Radiologic Technologists Code of Ethics when imaging the deceased just as he or she would for the living.4

AMA answers to questions about HIPAA

The privacy protections HIPAA affords are not limited durationally, therefore the medical record of a deceased patient is subject to all restraints on disclosure that are applicable to the record of a living patient.

 

[Skeptic Ginger]

...
Given that the "patient" was dead they are unable to consent or otherwise. Dead bodies have few (if any) rights.

Who told you that?

...As I read it the students already knew that the guy was dead so it's hardly news that could be termed "private information".

This is the same mistake UY made. It's a misunderstanding of what confidentiality applies to.

If I learn something about a person in the course of providing medical or nursing care of him/her, I cannot disclose that information except as needed to provide the care. It doesn't matter who else knows the same information.

If, OTOH, I learn something about a person that would otherwise be confidential if I had learned it while providing services, but I learn about it in some casual setting, I have no obligation to maintain confidentiality. It depends on how one comes to know the information, not whether anyone else also knows it.

 

[Skeptic Ginger]

It wasn't careless according to the court that ruled on the case.

Here's the thing: The medical profession has an obligation to keep confidential information private. That doesn't mean all information. I touched on this when I first asked her the question. When you visit your doctor, other people see you in the waiting room. The nurse will usually call out your name. Therefore, the fact that you visited the doctor is not confidential information. As you navigate around the office, you may see someone going into an x-ray room or a room where blood is drawn. That means you may know a little something about the type of care "Mr. Clark" is receiving.

Is that a breach of confidentiality? Of course not. It's simply not reasonable for people to expect 100% confidentiality because it would place an undue burden on the medical profession. In this case we have a morgue doing its duties and keeping a labeled jar in a cabinet. In their duties educating the public someone catches a glimpse of the name on the jar. Most likely the fact that this person was getting an autopsy is a matter of public record. It's not confidential.

We can come up with all sorts of scenarios where confidentiality is expected, but that doesn't make any difference as to whether it was expected and required under these circumstances. I'm willing to listen to an explanation as to why it's a "serious" breach in this case, but so far, nada.

You constantly ask people provide evidence of any and everything they post, and here you are posting erroneous information about confidentiality and no supporting sources, nada. This is my profession and I've been practicing in it for over 30 years.

You may not have noticed, but in the US in any doctor's office waiting room, you will typically be called by your first name. This has been true for quite a few years now.

I already noted that in the psych hospital I provide services in, no patient last names are used, even on the chart binder.

And your continual spouting of only private information being confidential and public info not being confidential is simply wrong. The standard is specifically how you come to know the information, not who else knows it.


So where is your evidence here that because people know someone is dead that means any details related to their autopsy are not confidential?

 

[Skeptic Ginger]

Please don't make this personal. Either defend your claims or don't. My motivation is irrelevant....

I don't see any defense of your claims here, are you unaware you are spouting unsupported facts?

...
You still haven't answered the very basic question: What confidential information was revealed?

The fact the brain is in a jar in the morgue IS confidential information. I can't help you if you don't understand that.

...Look, in many states autopsy reports are public records, and this has been affirmed by the courts. Autopsy reports can reveal quite a bit of information. In this case as far as I can tell the only thing revealed was, "This kid's brain is in a jar at the morgue." As best as I can tell even in states with closed autopsy reports the fact that a body is undergoing an autopsy is a matter of public record. That's not confidential information.

You made a bold assertion of a "serious breech [sic] of confidentiality," and I'm simply asking you to support that assertion. Perhaps you are aware of information that I am not.

A brain in a jar in the morgue is not an autopsy report.

And from your link:

Court left open the possibility that courts can seal autopsy reports “based on privacy or privilege concerns.”

So it is not a given that any and everyone can see anyone's autopsy report.



I posted above the AMA paper on confidentiality yet you ignored the most important concept in it. Confidentiality is a professional ethical responsibility, not just a legal one. You will notice it is a civil case, not a criminal case the OP is about in this thread.

From my previous post because you apparently missed it:

Dr. Cyril H. Wecht, a forensic pathologist and attorney who reviews cases like these but is not involved in the Shipley case, says the medical examiner was right to take out the brain for investigation but was wrong to openly display Shipley's name on it.
"You're talking about a matter of sensitivity and common sense," Wecht says. "Certainly if you're going to have student visitors, then you should not have names and numbers available to see."

 

[dtugg]

So a dead person in a coroner's office is a patient and any information gathered from his treatment (autopsy) is confidential, correct?

 

[Uncayimmy]

You constantly ask people provide evidence of any and everything they post...

Hmm...a skeptic on a skeptic's board asking people to provide evidence for their claims. Shame on me!

...and here you are posting erroneous information about confidentiality and no supporting sources, nada. This is my profession and I've been practicing in it for over 30 years.

I would think that with so much experience that you could have answered the question right off the bat and buried me with citations. Are you now simply telling me to take your word for it?

You may not have noticed, but in the US in any doctor's office waiting room, you will typically be called by your first name. This has been true for quite a few years now.

Can you show me where this is a requirement? Can you show me where an office has been sanctioned for doing that? To the best of my knowledge that falls under incidental disclosure:

http://hipaa.bsd.uchicago.edu/incidental_disc.html
While reasonable precautions should be used to avoid sharing patient information with those not involved in the patient's care, it is possible that minor amounts of patient information may be disclosed to people near where patient care is delivered or being coordinated. This is referred to as an incidental disclosure.

Here's a little more evidence for how you are wrong:

http://www.uihealthcare.com/depts/hipaa/qanda.html#b
Can staff still call out the names of patients in the waiting rooms?
Yes. The rule explicitly permits certain incidental disclosures that occur as a by-product of an otherwise permitted disclosure after UI Hospitals and Clinics has applied reasonable and appropriate safeguards.

I already noted that in the psych hospital I provide services in, no patient last names are used, even on the chart binder.

According to the HIPAA guidelines that is considered "highly confidential information" as noted below:

http://hipaa.bsd.uchicago.edu/incidental_disc.html
Conversations discussing PHI should be conducted in a private area or room, especially when discussions involve highly confidential information (i.e. Mental Illness or Developmental Disability, HIV/AIDS Testing or Treatment, Communicable Diseases, Venereal Disease(s), Substance (i.e. alcohol, drugs) Abuse, Abuse of an Adult with a Disability, Sexual Assault, Child Abuse and Neglect, Genetic Testing, Artificial Insemination, and Domestic Violence).

My citations above show just how wrong the following statement you made really is:

And your continual spouting of only private information being confidential and public info not being confidential is simply wrong. The standard is specifically how you come to know the information, not who else knows it.

So where is your evidence here that because people know someone is dead that means any details related to their autopsy are not confidential?

I never made any such claim. I proved conclusively that in some states the entire autopsy is a matter of public record. I said that in some states autopsy records are closed. What I have asked you to do is prove how the presence of a person's brain in a jar is confidential. So far we only have your assertion, and considering how your other assertions have been proven false, I don't trust your expert opinion in the least.

 

[Uncayimmy]

The fact the brain is in a jar in the morgue IS confidential information. I can't help you if you don't understand that.

This is based on your expert opinion?

A brain in a jar in the morgue is not an autopsy report.

Did somebody say that it was?

And from your link:So it is not a given that any and everyone can see anyone's autopsy report.

I never said it was. I said they are public records. I didn't think I needed to point out that people can ask for public records to be sealed, and that the request may or may not be granted. People can also request sealed records to be opened. It all depends on what is confidential, which is the heart of this discussion. You haven't done anything besides assert that a jar with a person's name on it is confidential.

I posted above the AMA paper on confidentiality yet you ignored the most important concept in it. Confidentiality is a professional ethical responsibility, not just a legal one. You will notice it is a civil case, not a criminal case the OP is about in this thread.

I didn't ignore anything.

From my previous post because you apparently missed it:

Already resoundingly debunked.

 

[bluesjnr]

Originally Posted by bluesjnr
Given that the "patient" was dead they are unable to consent or otherwise. Dead bodies have few (if any) rights.

Who told you that?

Are you serious? The guys brain was in jar! He'd been buried for two months. He was killed in a car crash and therefore was never given the opportunity to consent or otherwise. Where are you going with this question SG?

ETA - I just realised where you were going with this question SG! You might have snipped the first sentence off when you quoted me! I have not extensively researched the rights of the a dead body and in doing so this afternoon come up with remarkably little. This suggests that there is not much in the way of legislation apart from that covering burial and estate and the rights of next of kin. You seem to imply that you know better and I'd be glad if you could educate me in this regard.

This is the same mistake UY made. It's a misunderstanding of what confidentiality applies to.

No, it is not a mistake. You are applying confidentiality incorrectly. According to the article the guy was DOA.

If I learn something about a person in the course of providing medical or nursing care of him/her, I cannot disclose that information except as needed to provide the care. It doesn't matter who else knows the same information.

The guy was DOA. Using your logic, what would you say to his parents if they asked about the condition of your patient.

If, OTOH, I learn something about a person that would otherwise be confidential if I had learned it while providing services, but I learn about it in some casual setting, I have no obligation to maintain confidentiality. It depends on how one comes to know the information, not whether anyone else also knows it.

Which would be fine if it wasn't for the fact that the guy was DOA!

 

[Skeptic Ginger]

So a dead person in a coroner's office is a patient and any information gathered from his treatment (autopsy) is confidential, correct?

Not exactly. Information about the deceased can include medical information. Death and cause of death are medical diagnoses. And patient confidentiality does not cease being confidential at death as has been suggested here, regardless of how the law handles the confidentiality of autopsy reports. If I have a medical record showing someone had a drug problem or an STD, and that information has nothing to do with the autopsy, for example, I can't just ignore patient confidentiality once the patient dies.

Are none of you reading the stuff I've linked to? This is why it is irksome to bother citing supporting documentation. Read the Morgue protocol stuff I posted. Read the AMA discussion of confidentiality and confidentiality after death. It's all in there.

 

[Skeptic Ginger]

Are you serious? The guys brain was in jar! He'd been buried for two months. He was killed in a car crash and therefore was never given the opportunity to consent or otherwise. Where are you going with this question SG?

ETA - I just realised where you were going with this question SG! You might have snipped the first sentence off when you quoted me! I have not extensively researched the rights of the a dead body and in doing so this afternoon come up with remarkably little. This suggests that there is not much in the way of legislation apart from that covering burial and estate and the rights of next of kin. You seem to imply that you know better and I'd be glad if you could educate me in this regard.



No, it is not a mistake. You are applying confidentiality incorrectly. According to the article the guy was DOA.



The guy was DOA. Using your logic, what would you say to his parents if they asked about the condition of your patient.



Which would be fine if it wasn't for the fact that the guy was DOA!

All of these issues can be addressed together. After death, and when a person is unable to consent but still alive, such as someone unconscious, there are simple rules for who can speak for the patient. It's the next of kin if "Durable Power of Attorney" has not been assigned by the person earlier.

So in the case of the DOA kid, first, consent for care in the ED is not needed if an emergency exists and a patient is not capable of giving consent. This is true of minors also so if your kid is brought into an ED and needs treatment for a life threatening condition, consent is implied. We are talking about confidentiality but this is related. There is conflict on occasion when the police want information like blood alcohol level and the ED is not willing to release the information without a court order. HIPAA redefined the rules here when it comes to the EMS personnel communicating with police at accident scenes. If the patient tell the medic they are high, the medic cannot tell the police what was said, for example, unless and until the court orders it.

Gunshot wounds are reportable by law as are certain communicable diseases regardless of patient wishes.

But when the patient is incapacitated or dead, as soon as next of kin is identified and contacted, they are now the person who consents for the patient or deceased. And that next of kin or person assigned with durable power of attorney, they now speak for the deceased. The deceased is not left with no rights.

And when there is no NOK or DPA, the court can assign a guardian including a guardian to speak for the deceased.


Think about it. If you had no rights after death, why would we need consent for organ donation?

 

[Skeptic Ginger]

This is based on your expert opinion?

Yes, as a matter of fact. I have a Master's degree in the science of advanced practice nursing, I'm board certified in advanced family practice, infection control and occupational health. I've been and advanced practice nurse (ARNP) for 25 years including having a successful private practice for the last 20 providing medical care, educational and consulting services. And I was a nurse before that with experience in med-surg, ICU, pediatrics and public health. And as an ARNP before starting my own practice I worked in the drug and alcohol abuse field which has specific confidentiality laws. Currently I provide consulting services for a psych hospital which also has its own set of confidentiality laws. There are specific laws about reporting and communicating STD and infectious disease information and I am a paid consultant which includes being responsible for providing that information.

Did somebody say that it was?

This is a non sequitur.

...
I didn't ignore anything.

Then one has to wonder why you don't understand the concept of professional conduct and misconduct being a separate issue from specific places the law addressed certain matters of confidentiality. Because the AMA article addressed this.

Already resoundingly debunked.

By your expert opinion???? So you are claiming Dr. Cyril H. Wecht, a forensic pathologist and attorney whose opinion I quoted on the matter was debunked? Where and by whom?

 

[Skeptic Ginger]

Hmm...a skeptic on a skeptic's board asking people to provide evidence for their claims. Shame on me!

Straw man.The issue is not asking someone to support a claim. The issue is making every discussion a pissing contest. Some things can actually be discussed between skeptics in this forum without making every post some kind of accusation of a falsehood.

I would think that with so much experience that you could have answered the question right off the bat and buried me with citations. Are you now simply telling me to take your word for it?

Since I did answer you right away and included sufficient citation, this is simply false.

Can you show me where this is a requirement? Can you show me where an office has been sanctioned for doing that? To the best of my knowledge that falls under incidental disclosure:

Here's a little more evidence for how you are wrong:

According to the HIPAA guidelines that is considered "highly confidential information" as noted below:

My citations above show just how wrong the following statement you made really is:

I never made any such claim. I proved conclusively that in some states the entire autopsy is a matter of public record. I said that in some states autopsy records are closed. What I have asked you to do is prove how the presence of a person's brain in a jar is confidential. So far we only have your assertion, and considering how your other assertions have been proven false, I don't trust your expert opinion in the least.

You have not made the case you claim you've made and I stand by what I've posted.

You have claimed that because autopsy reports are public record, ergo the morgue had no duty to prevent high school kids in a forensics club from seeing a jar with a brain in it labeled with their friend's name on it. But that does not follow.

The court ruling clearly implied that had the brain been put on PUBLIC display there would have been a case. So how is that is there was no duty of confidentiality here?

I have explained that if the kids had a legit reason to see the name on the brain jar because they were legitimate forensic students, then they had the duty not to disclose the information to their peers. That just wasn't pursued in the lawsuit. Are you claiming forensic students had no duty not to disclose the fact they saw their friend's brain in the morgue? Certainly people damaged by a breach of confidentiality (the parents of the deceased) are not obligated to sue because of it.

And the reaction of the kids to seeing their friend's brain in the morgue should make it obvious why any professional responsible for high school kids touring a morgue should not allow the students to see the name of a deceased on a brain in a jar on the shelf in the morgue. Most of the experts weighing in, in the news articles, addressed the legitimate reason for keeping the brain. But there certainly wasn't a batch of experts weighing in saying it was OK the kids saw their friend's name on the jar. And I posted one qualified expert interviewed who stated the obvious, it was a stupid mistake on the ME's part to not prevent the students seeing actual names.

 

[Uncayimmy]

So, basically it boils down to this:

You say it was a "serious breech [sic] of confidentiality" and that we should believe you because you're an expert. The "confidential" information was that the kid's brain was in the morgue.

While also testifying as an expert you claimed that HIPAA prevented medical personnel from calling out your name in the waiting room. I showed conclusively that this is not the case. I also showed that HIPAA allows for incidental disclosure of minor details.

I showed conclusively that in some states autopsies are a matter of public record as are death certificates. I showed that the fact that an autopsy is performed is a matter of public record even if the details are sealed. The court ruled that nothing improper was done by the morgue. By your account nobody in the news is talking about a HIPAA violation. Since this was featured in the news, it's reasonable to assume that those in charge of HIPAA and those in charge of the morgue would address it if it were a serious breach.

Despite this you insist based on your expert opinion that the name on a specimen jar is confidential information and that students seeing it was a "serious" breach.

I'm glad we got that cleared. Next time if you're going claim "because I said so" just say so up front and save us the time. Thank you. That is all.

 

[dtugg]

Not exactly. Information about the deceased can include medical information. Death and cause of death are medical diagnoses. And patient confidentiality does not cease being confidential at death as has been suggested here, regardless of how the law handles the confidentiality of autopsy reports. If I have a medical record showing someone had a drug problem or an STD, and that information has nothing to do with the autopsy, for example, I can't just ignore patient confidentiality once the patient dies.

Are none of you reading the stuff I've linked to? This is why it is irksome to bother citing supporting documentation. Read the Morgue protocol stuff I posted. Read the AMA discussion of confidentiality and confidentiality after death. It's all in there.

So a coroner couldn't, for example, tell the media how a person died? Because how a person dies is a medical diagnosis and patient confidentiality does not cease being confidential at death?