Occupational health nurses seek confidentiality law

Group wants employee health information protected

The American Association of Occupational Health Nurses (AAOHN) is urging Congress to adopt broad legislation providing protection for employees' health information.

In testimony before the Senate Labor and Human Resources Committee, Bonnie Rogers, DrPh, COHN-S, RN, FAAN, president of the Atlanta-based association, emphasized the need for a broad definition of "health information," limited disclosure of work site health information without an employee's consent, and strong penalties for inappropriate disclosure.

Federal statutes presently guarantee confidentiality of medical information only in connection with the Americans with Disabilities Act. However, each state's Nurse Practice Act requires nurses to maintain their patients' confidentiality or risk losing their professional licensure.

Too often, Rogers says, occupational health nurses are caught between management demands for intimate medical facts about employees and nurses' ethical responsibility to protect employees' privacy. (See related story in Hospital Employee Health, November 1996, pp. 121-124.) Members of the AAOHN, which represents more than 13,000 occupational and environmental health nurses, have been lobbying Congress in support of the Medical Information Protection Act of 1998, drafted by Sen. Robert Bennett (R-UT).

"On more than one occasion, an occupational health nurse has lost his or her job attempting to protect an employee's privacy. This is not a theoretical issue," says Rogers, who also is an associate professor of nursing at the University of North Carolina at Chapel Hill.

Rogers told committee members the story of an occupational health nurse from Kentucky who was fired when she refused to violate her ethical obligations by providing her employer with access to the results of employees' routine physical examinations.

The draft legislation would prevent abuses such as inappropriate access to work site health records, and "it would also give individuals the right to access their own health records, require individual consent for the disclosure of health information with few exceptions, provide enforcement through civil penalties and criminal sanctions for illegal disclosures, and provide uniform legal protection across the nation," Rogers says.