Confidentiality Issues In Medical practice

You are seeing patients in clinic when two men in dark suits and dark glasses come in and show you badges marking them as members of a federal law enforcement agency. The identification is legitimate. These  'men in black' inform you that they are making a "minor investigation" of one of your patients. They ask to look at the patient's chart for a few minutes, saying, "You wouldn't want to interfere with a federal investigation, would you?"

What should you do?

a. Give them the chart.

b. Give them the chart but watch what they do with it.

c. Ask them to sign a release for the chart so you are  absolved of responsibility.

d. Tell them you cannot show them the chart unless there is a signed release from the patient.

e. Tell them that you can give copies but not the original record.

f. Don't give them the chart but read the relevant information to them.

Answer: d. Tell them you cannot show them the chart unless there is a signed release from the patient.

Discussion: You cannot release a patient's medical records unless there is a clear, signed release from the patient or there is a court order. This is true no matter who is asking. If the federal agents have a court order for the records then they have a right to the information. A court order or a warrant can be used by the judicial system to violate the confidentiality.
Although the medical record as a physical object is the property of the physician or health care facility, the information is the property of the patient . In a sense the information is like a  person's house. No one has the right to enter your home without either your permission or a court order allowing the investigation. This is also true even if the people requesting it are law enforcement agents. We all have a constitutional right against illegal search and seizure of our property.