Analyze the attached case using the 4-topic analysis: APA FORMAT
1. Introduction: Identify the major theme(s) of the case: (i.e. confidentiality and truthfulness, (2 paragraphs)
2. Medical (or Healthcare) Indications (2 paragraphs)
3. Patient (or Client) Preferences (2 paragraphs)
4. Quality of Life (2 paragraphs)
5. Contextual Features (2 paragraphs)
6. Conclusion/Solution/Decision (2 paragraphs)

Principles of Confidentiality and Truthfulness

Read Case One:
This case study challenges the importance of confidentiality and truthfulness in medicine.
Marxavi Angel Martinez is a 23 year-old library employee in North Carolina
who was brought to the US legally at three years of age, but her parents overstayed their Visas. Martinez was then raised in the US, becoming an honor student, cheerleader, library clerk, and now mother. She has been married for 3 years. Her husband has a work Visa and is employed by a local restaurant. They are devout Roman Catholics and are members of a local church.
Marxavi received her prenatal care at the Alamance County (NC) public health department this past year. This is her first pregnancy. She and her husband Juan (here on a work Visa) were married several years ago. By 28 weeks a placenta previa was determined and followed with ultrasound every two weeks. Betamethasone was administered once for the possibility of premature delivery. By 34 weeks the placenta was noted to have migrated away from the cervical os and also noted was a fetus with cord entanglement. On closer inspection, the fetus had a loop of umbilical cord around the neck. Due to changes in fetal behavior and fetal heart rate a fetal heart rate monitor was placed at the home for closer observation.   
Meanwhile, during a recent State Bureau of Investigation inquiry into this health department, a judge orders the release of confidential medical records (remember that HIPAA permits disclosure to law enforcement agencies, homeland
security, insurance companies: see HIPAA exemptions below). The sheriff shows up at the clinic and demands access to medical records. Physicians and public health officials are concerned about the effects this arrest may have on residents, legal and otherwise, and their communities when seeking health care. In particular, as Marxavi’s physician, you are concerned that if they turn over the records your patient may be deported before they can complete her care and safely deliver her baby.
What do you do? In your solution, elaborate on how do you see the relationship between the two "spheres" of law and ethics? Most agree there is overlap, but how much overlap, and which takes ultimate precedence in the provision of health care? Are the exemptions to the HIPAA law ethical? For example, is it legal for law enforcement officials to use public health department medical records to identify and deport illegal immigrants?

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A discussion of confidentiality and truthfulness in terms of healthcare as it relates to a patient one immediately thinks of the federal and state laws in the collection, storage, transmission and disclosure of personal health information. These laws were put in place to protect the privacy of the patient while disclosure of this information requires the signed consent of the patient. Legally and ethically it is the responsibility of the healthcare provider to protect the privacy of the patient, obtain informed consent to disclose this information without which can lead to the charge of negligence or possible medical malpractice. From an industry perspective informed consent is an ethical issue as it relates to the autonomy of the patient and their right to choose what procedures are performed on their person. Conversely autonomous consent is an implied action, for example an individual presents for an appointment.
Disclosure on the other hand is a major factor in terms of a legal and ethical aspect as it relates to informed consent. Disclosing a patient’s condition, method of treatment or alternative treatment can appear simple in nature but it is not always the case....
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