Family Nurse Practitioner Exam

Under what circumstance is patient confidentiality breached?

1. Medical information is given to a spouse

2. Records are subpoenaed

3. Reports are sent to the Public Health Department

4. Records are released to insurance companies

The correct answer is: Medical information is given to a spouse

In the context of patient confidentiality, breaches occur when private medical information is disclosed without the patient's consent and does not fall under exceptions that permit such disclosures. When medical information is given to a spouse without the patient’s explicit permission, it can be considered a breach of confidentiality. This situation typically does not involve any overriding legal or medical obligations that would justify the disclosure, thereby undermining the trust inherent in the patient-provider relationship. Conversely, the act of releasing records in response to a subpoena is mandated by law and typically occurs in legal situations, which does not count as a breach of confidentiality. Similarly, sharing reports with the Public Health Department is often required by law to monitor and control communicable diseases and is thus permissible under public health laws. Lastly, the release of records to insurance companies is also governed by regulations that allow for the sharing of pertinent information for the purposes of billing and reimbursement, assuming consent has been previously given by the patient. Therefore, these actions do not constitute a breach of confidentiality as they are conducted within the framework of legal and ethical guidelines.