Confidentiality of health information postmortem

Context.-Recent discussions of health care privacy have prompted new concer ns over the control of private health information after a patient's death. The importance of confidentiality protections postmortem is compounded as g enetic technologies and research capabilities advance and public interest i n this information increases. Objective.-The Council on Ethical and Judicial Affairs of the American Medi cal Association developed this report to guide physicians in the management of patients' health information postmortem. Participants.-This report was developed by the 9 physician members of the C ouncil on Ethical and judicial Affairs with the assistance of staff from th e Ethics Standards Group at the American Medical Association. Evidence.-Literature searches in the MEDLINE and BIOETHICSLINE databases us ing the search terms postmortem and health information qualified with confi dentiality or privacy yielded a combined total of 129 references. Additiona l references were culled from policies of a number of health care organizat ions. Consensus Process.-The Council on Ethical and judicial Affairs solicited su ggestions from the federation of state medical and specialty societies befo re drafting this report. A copy of the report was sent to the College of Am erican Pathologists for comment. It was then adopted by a majority vote of the House of Delegates of the American Medical Association. Conclusions.-The report emphasizes the importance of maintaining confidenti ality for information held within a deceased patient's medical record. Howe ver, these protections are subject to certain exceptions. Confidentiality c an be upheld when such information is used for educational or research purp oses by removing individual identifiers. For disclosures in which the ident ity of the deceased patient is known, a number of considerations are provid ed to assess when disclosure would be ethically permissible.