Revised Ethical Code of Conduct for the Group

[Guest guest]

Below

--- <attiliodalberto

wrote:

Please note

> that this group

> only contains healthcare professionals unlike other

> groups

 

Hi again Attilio, May I ask how do you know this

really for sure? I don't remember having to send in

proof of liscensure to join.

 

I discussed this situation with a friend of mine

yesterday that is an attorney with a lot of experience

in this area (was once the malpractice attorney for an

entire state's medical board) and who is married to an

MD. I just wanted to be sure I was not leading you

astray with my info as I am not myself an attorney.

 

She told me the standard of confidentiality in a

medical situation is " can the person be identified by

the information given " so a really simple example

might be if there's only one black person in town, the

local MD's should not mention that the person they are

discussing is black along with the not disclosing the

name, SS#, and any other info extraneous to the case

that might make identity likely, etc.

 

I am certain we can find a way to discuss the

particulars of cases without giving so much extraneous

info. For instance, (this is from memory, I haven't

reread the post so might not be accurate) was it

really necessary to know that that woman was hung for

long periods upside down? Or that the form of

spirituality her parents practiced was Native American

and Wicca? and more that I don't remember right now.

 

And I still contend the DOB should be given

backchannel to those who can use it.

 

I am on several homeopathic lists. Two have a guy

Julian Winston who is rabid on this issue, and they

have managed to discuss lots of cases over the years

without seeming to violate confidentiality. Julian

jumps all over the list whenever there's a slip, but

there's not many anymore.

 

This is a very important issue and I commend you for

working with it.

 

Now go and enjoy your sun as it's still the Easter

Weekend here in the Non-Orthadox Christian West. Me,

I will just sit here and shiver! Grrrrrrrrrrr!

 

Christina

 

 

 

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[Guest guest]

Hi Christina!

 

OK, let's get this straight. Some person who you named who is on a couple

of *homeopathy* lists thinks that if he has a date of birth, nationality of

the mother and religion of the father and some details of abusive religious

practices (that you can't remember and can't be bothered to re-read) he can

identify the person in a town of about 350,000 (or 350, for that matter)

and that I was remiss to provide such depth of detail in the case. You

think you might agree with that. Am I reading this correctly?

 

I posted the case so people could study the *case* and comment on the

*case*. You are commenting on whether or not I should have posted the case

in enough detail to be of any use for that purpose. Perhaps *you* should go

into law? You might be good at law. Or maybe politics.

 

Why don't we just say that everyone on the list is bound by a professional

non-disclosure ethic and agrees to confidentiality? That plus the fact that

there really isn't enough here that *anyone* could in a million years

identify the person should cover it. The person who *thinks* he can

identify the patient is still bound by confidentiality to not disclose or

use what he *thinks* he maybe can find out if he devotes his life to the

effort.

 

This is not to get into the issue of whether the details that you can't

remember and can't be bothered to re-read are " extraneous " to the case, as

you assert. Several people, myself included, think these " extraneous "

details are of some significance, but perhaps not to you if you practice a

different, uh, style.

 

At 10:26 AM 4/11/2004, you wrote:<snip>

>She told me the standard of confidentiality in a

>medical situation is " can the person be identified by

>the information given " so a really simple example

>might be if there's only one black person in town, the

>local MD's should not mention that the person they are

>discussing is black along with the not disclosing the

>name, SS#, and any other info extraneous to the case

>that might make identity likely, etc.

>

>I am certain we can find a way to discuss the

>particulars of cases without giving so much extraneous

>info. For instance, (this is from memory, I haven't

>reread the post so might not be accurate) was it

>really necessary to know that that woman was hung for

>long periods upside down? Or that the form of

>spirituality her parents practiced was Native American

>and Wicca? and more that I don't remember right now.

>

>And I still contend the DOB should be given

>backchannel to those who can use it.<snip>

 

Regards,

 

Pete

[Guest guest]

Pete and list, As I said in my post immediately

following the one you are responding to, this was a

private post to Attilio I accidentally posted to the

list. I apologize for that error.

 

Pete, There was a lot more private discussion you were

not privy to. I will not argue specifics on the list

in public as it would defeat the purpose of asking for

more confidentiality for patients whose cases are

posted to the list. If you would like to take this

off-list, I will spend some time to discuss with you

why I believe it is important to not post extraneous

and (even if not extraneous but) possibly identifying

detail to a public media such as an email list (even

when it is supposed to be healthcare providers

only)--esp in light of HIPPA in the USA. Of course,

HIPPA only affects you if you are practicing in the

USA. Not so of medical ethics--that’s universal.

 

In general terms, however, I can say that I feel our

patients give us a sacred trust, especially when they

have been so deeply wounded. In all cases, but

especially ones like that, to err on the side of

caution and compassion in making absolutely certain

that they are not wounded by the abusive situation

once again through OUR actions is the least we can do.

I have seen some of the most grievous damage come

from the violation of trust by practitioners. Not to

keep confidentiality strictly is such a violation of

trust unless one has permission to disclose specific

details. Please note I am not speaking of Oriental

Medicine specific diagnostic terms that might confuse

the patient, I am talking of “real world” details that

anyone would understand. Therefore I believe that it

is our responsibility to err on the side of less info

rather than more. We can always post privately to

anyone who asks for more info.

 

Thanks for your time. Christina

 

--- Pete Theisen <petet wrote:

> Hi Christina!

>

> OK, let's get this straight. Some person who you

> named who is on a couple

> of *homeopathy* lists thinks that if he has a date

> of birth, nationality of

> the mother and religion of the father and some

> details of abusive religious

> practices (that you can't remember and can't be

> bothered to re-read) he can [snip]

 

 

 

Tax Center - File online by April 15th

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[Guest guest]

Hi Christina!

 

On-list will be fine, thank you very much. If you wish to drop the on-list

discussion and instead gossip to anyone who will entertain your gossip

about how wrong, etc. the rest of us are, this is your prerogative. I would

be deeply embarrassed to do what you are doing, to tell you the truth, and

I *wouldn't* do it. It makes me wonder what your agenda really is to want

to hide a discussion about how the list is used away from the members of

the list who would be directly affected by any decision arising from the

discussion.

 

I discussed this issue with the patient today. She did not see how anyone

could identify her from what I had posted and neither do I. In addition she

was grateful to those who added *positive* insights into her case, and

offered her thanks to them, as I do once again as well. She already knew

beforehand that I might be posting the case since this is part of my

patient orientation discussion, that I routinely post cases for comment and

study.

 

I challenge *anyone* (as a demonstration, of course) to identify any

patient I have ever posted a case about, this should put it to rest pretty

quickly since no one will be able to identify any of these short of

breaking into my office and then rifling through my file cabinet which just

might be locked. By then, of course, they will have violated not only HIPAA

but also some more basic criminal codes as well. Most people are a *lot*

more interested in the positive aspects of on-list case discussion than

they are in irrelevant side issues such as whether or not someone *might*

be able to crack my privacy procedure.

 

HIPAA does *not* require us to re-create Ft. Knox or the Pentagon in our

offices. According to the training on HIPAA that I received, reasonable

privacy procedures are all that the law requires. Endless hand wringing and

agonizing is not required, however appealing this may be to those with

nothing better to do. Of course, a lawyer will always paint the most

pessimistic scenario - more money for him/her - to these opportunists HIPAA

induced practitioner hysteria is a cash cow. If you have to practice

medicine by lawyer cash-lusts you may as well become a lawyer yourself

because you won't be practicing medicine anymore.

 

What about *trying* to identify a case-study patient from the details of

the case and an in-house ID number? If done with the intent of misusing the

information, would not this effort alone violate HIPAA, even if the person

did *not* succeed? Would not the criminal intent create the crime?

 

At 09:29 AM 4/12/2004, you wrote:<snip>

There was a lot more private discussion you were not privy to. <snip> take

this off-list <snip>

 

 

Regards,

 

Pete

[Guest guest]

Hi all,

 

Please note that after consulting and a number of others, I

have revised the group's terms of use. Please look out for it in the

netiquette file which goes out automatically every month.

 

Attilio

 

Christina <tcmresources> wrote:

 

> Hi again Attilio, May I ask how do you know this

> really for sure? I don't remember having to send in

> proof of liscensure to join.

>

> I discussed this situation with a friend of mine

> yesterday that is an attorney with a lot of experience

> in this area (was once the malpractice attorney for an

> entire state's medical board) and who is married to an

> MD. I just wanted to be sure I was not leading you

> astray with my info as I am not myself an attorney.

>

> She told me the standard of confidentiality in a

> medical situation is " can the person be identified by

> the information given " so a really simple example

> might be if there's only one black person in town, the

> local MD's should not mention that the person they are

> discussing is black along with the not disclosing the

> name, SS#, and any other info extraneous to the case

> that might make identity likely, etc.

>

> I am certain we can find a way to discuss the

> particulars of cases without giving so much extraneous

> info. For instance, (this is from memory, I haven't

> reread the post so might not be accurate) was it

> really necessary to know that that woman was hung for

> long periods upside down? Or that the form of

> spirituality her parents practiced was Native American

> and Wicca? and more that I don't remember right now.

>

> And I still contend the DOB should be given

> backchannel to those who can use it.

[Guest guest]

Maybe you could grow a little skin. Come on guys,,,, Yes I see the

point, but his comments weren't meant to offend and in all honesty, there are

legitime religious rituals that I find are bizarre. So what? Who really cares

whether anyone else considers what we do as bizarre. Have you read what bizarre

means?

 

Main Entry: [1]bi·zarre

Pronunciation: b & -'zär

Function: adjective

Etymology: French, from Italian bizzarro

circa 1648

: strikingly out of the ordinary: as a : odd, extravagant, or eccentric in

style or mode b : involving sensational contrasts or incongruities

 

Not to bad is it. Doesn't belittle anyone. Repeating the beleife that

someone found the rituals to be terrifying does not denigrate a religion in

any way.

 

Your objections to what was written shows an immaturity that I find

ridiculous.

 

Chris

 

 

 

In a message dated 4/18/2004 1:03:15 PM Eastern Daylight Time,

aianmeng writes:

Attilio,

 

While we are at it, can we please keep inappropriate comments about

religion off

of this list? I, for one, found Pete's comments concerning Native American and

Wiccan ritual highly repugnant, inaccurate and offensive.

 

 

Pete wrote:

 

" She also had terrifying experiences as a child being forced to undergo

bizarre

religious ordeals. "

 

and...

 

" This was Native American ritual on her mother's side and Wicca on her

father's

side. When she matured she converted to Jehovah's Witness, an improvement from

her perspective. "

 

Why the need to affiliate those ordeals with a religion or religions in a

medical post?

 

 

 

[Guest guest]

Attilio,

 

While we are at it, can we please keep inappropriate comments about

religion off

of this list? I, for one, found Pete's comments concerning Native American and

Wiccan ritual highly repugnant, inaccurate and offensive.

 

 

Pete wrote:

 

" She also had terrifying experiences as a child being forced to undergo

bizarre

religious ordeals. "

 

and...

 

" This was Native American ritual on her mother's side and Wicca on her

father's

side. When she matured she converted to Jehovah's Witness, an improvement from

her perspective. "

 

Why the need to affiliate those ordeals with a religion or religions in a

medical post?

 

My concerns regarding the above statements have less to do with patient

confidentiality

than with religious bigotry. The above statements come off this way. In

this post, Native

American and Wiccan religions have been correlated to events that are NOT

part of

their religious practices. The implication is that the practices of these

religions are

" bizarre " and " terrifying, " when those activities stated are not

representative of the

religions they've been associated with.

 

First off, those activities have NOTHING to do with Wicca or other forms of

Paganism,

nor any form of Native American tribal ritual that I've ever seen. Further,

these kinds of

remarks are highly inappropriate on a list with over 700 members who may

practice

different religions, including one of those mentioned. This list is not the

place for religious

intolerance or misrepresentation. I'm sure most members of this list

realize that what an

individual or a small group may do is not necessarily reflective of their

religion, but there

may be a few who do not. It is inappropriate, and highly inaccurate, to

create the impression

otherwise, whether intentional or not.

 

Can we please leave such extraneous and irrelevant comments, especially

concerning religion,

off of this list? There is too much room for personal biases and religious

bigotry to enter

such posts, and this just isn't the place, nor is there a need for it.

 

Many thanks,

 

Andrea

[Guest guest]

If he had commented on a religion in a positive of negative way, I might

see your point. But he didn't. He mearly indicated the source of the rituals

involved in the child's terror.

Not being able to even mention a religion, is ludicrous. To what end

is this level of censorship?

 

There was no preaching nor defamation. Please save censoring posts to

where there may be damage to our group or the people in it. There was clearly

none of that going on here.

 

Chris

 

 

 

In a message dated 4/18/2004 7:01:36 PM Eastern Daylight Time,

attiliodalberto writes:

Religious comments are not allowed on this group, whether portrayed

in a positive or negative perspective.

 

Attilio

 

Ai An Meng <aianmeng@s...> wrote:

> Attilio,

>

> While we are at it, can we please keep inappropriate comments

about

> religion off

> of this list? I, for one, found Pete's comments concerning Native

American and

> Wiccan ritual highly repugnant, inaccurate and offensive.

>

>

> Pete wrote:

>

> " She also had terrifying experiences as a child being forced to

undergo

> bizarre

> religious ordeals. "

>

> and...

>

> " This was Native American ritual on her mother's side and Wicca on

her

> father's

> side. When she matured she converted to Jehovah's Witness, an

improvement from

> her perspective. "

>

> Why the need to affiliate those ordeals with a religion or

religions in a

> medical post?

>

> My concerns regarding the above statements have less to do with

patient

> confidentiality

> than with religious bigotry. The above statements come off this

way. In

> this post, Native

> American and Wiccan religions have been correlated to events that

are NOT

> part of

> their religious practices. The implication is that the practices

of these

> religions are

> " bizarre " and " terrifying, " when those activities stated are not

> representative of the

> religions they've been associated with.

>

> First off, those activities have NOTHING to do with Wicca or other

forms of

> Paganism,

> nor any form of Native American tribal ritual that I've ever seen.

Further,

> these kinds of

> remarks are highly inappropriate on a list with over 700 members

who may

> practice

> different religions, including one of those mentioned. This list

is not the

> place for religious

> intolerance or misrepresentation. I'm sure most members of this

list

> realize that what an

> individual or a small group may do is not necessarily reflective

of their

> religion, but there

> may be a few who do not. It is inappropriate, and highly

inaccurate, to

> create the impression

> otherwise, whether intentional or not.

>

> Can we please leave such extraneous and irrelevant comments,

especially

> concerning religion,

> off of this list?

 

 

 

[Guest guest]

Religious comments are not allowed on this group, whether portrayed

in a positive or negative perspective.

 

Attilio

 

Ai An Meng <aianmeng@s...> wrote:

> Attilio,

>

> While we are at it, can we please keep inappropriate comments

about

> religion off

> of this list? I, for one, found Pete's comments concerning Native

American and

> Wiccan ritual highly repugnant, inaccurate and offensive.

>

>

> Pete wrote:

>

> " She also had terrifying experiences as a child being forced to

undergo

> bizarre

> religious ordeals. "

>

> and...

>

> " This was Native American ritual on her mother's side and Wicca on

her

> father's

> side. When she matured she converted to Jehovah's Witness, an

improvement from

> her perspective. "

>

> Why the need to affiliate those ordeals with a religion or

religions in a

> medical post?

>

> My concerns regarding the above statements have less to do with

patient

> confidentiality

> than with religious bigotry. The above statements come off this

way. In

> this post, Native

> American and Wiccan religions have been correlated to events that

are NOT

> part of

> their religious practices. The implication is that the practices

of these

> religions are

> " bizarre " and " terrifying, " when those activities stated are not

> representative of the

> religions they've been associated with.

>

> First off, those activities have NOTHING to do with Wicca or other

forms of

> Paganism,

> nor any form of Native American tribal ritual that I've ever seen.

Further,

> these kinds of

> remarks are highly inappropriate on a list with over 700 members

who may

> practice

> different religions, including one of those mentioned. This list

is not the

> place for religious

> intolerance or misrepresentation. I'm sure most members of this

list

> realize that what an

> individual or a small group may do is not necessarily reflective

of their

> religion, but there

> may be a few who do not. It is inappropriate, and highly

inaccurate, to

> create the impression

> otherwise, whether intentional or not.

>

> Can we please leave such extraneous and irrelevant comments,

especially

> concerning religion,

> off of this list? There is too much room for personal biases and

religious

> bigotry to enter

> such posts, and this just isn't the place, nor is there a need for

it.

>

> Many thanks,

>

> Andrea

[Guest guest]

At 07:00 PM 4/18/2004, you wrote:

>Religious comments are not allowed on this group, whether portrayed

>in a positive or negative perspective.

>

>Attilio

 

This is ... ridiculous lighten up Attilio

[Guest guest]

To all,

 

I think this particular situation wherby the practitioner reveals his patient's

reactions towards his parent's religious practices is a valid piece of the

patient's history. If the patient regards these practices as weird even if it

is not preceived as weird by others it is significiant to him/her. The patient

may not report the religious practices of the group accurately or as

representative of the majority but his/her reaction to them is what is

significant. Now if the acupuncture/DOM practitioner comments of these religious

practices ignorantly, then well, I can see how someone knowledgeable about them,

or, more to the heart, someone who is racially connected would feel offended. I

really don't think the px who relayed the story to us had any intention of

offending anyone. I think the px's intention was illustrative. It revealed the

patient's reaction to these factors.

 

Thoughts,

 

Carole

 

" David Sontag, DOM " <acudoc wrote:

At 07:00 PM 4/18/2004, you wrote:

>Religious comments are not allowed on this group, whether portrayed

>in a positive or negative perspective.

>

>Attilio

 

This is ... ridiculous lighten up Attilio

 

 

 

 

Membership requires that you do not post any commerical, swear, religious, spam

messages,flame another member or swear.

 

To change your email delivery settings,

Chinese Medicine/ click ‘edit my

membership' on the right hand side and adjust accordingly.

 

If you , it takes a few days for the messages to stop being

delivered.

 

 

 

 

 

 

[Guest guest]

Hi Andrea!

 

This is how the lady presented the case. What would you say if a patient

told you something like that, that her experience was inappropriate? Maybe

you would have told her she was biased and bigoted? Or would you have told

her she was highly repugnant, inaccurate and offensive? Maybe you would

have just called her a liar, as you *seem* to be calling me.

 

Oh, and don't try to say that religious experience is not related to

holistic medicine. If you think like that, you need to become an allopathic MD.

 

If we are going to be politically correct, we aren't going to be anything

*but* politically correct.

 

At 01:06 PM 4/18/2004, you wrote:

>Attilio,

>

>While we are at it, can we please keep inappropriate comments<snip>

 

Regards,

 

Pete

[Guest guest]

Hi David!

 

You know, I got two comments on the case itself, if I recall correctly!

Should I have even tried?

 

At 11:14 PM 4/18/2004, you wrote:

>At 07:00 PM 4/18/2004, you wrote:

> >Religious comments are not allowed on this group, whether portrayed

> >in a positive or negative perspective.

> >

> >Attilio

>

>This is ... ridiculous lighten up Attilio

 

Regards,

 

Pete

[Guest guest]

Pete wrote:

 

<<<This is how the lady presented the case. What would you say if a

patient told you something like that, that her experience was

inappropriate?>>>

 

Pete,

 

I would have paid attention to the circumstances causing the trauma,

not made note of the religions the patient named. I certainly

wouldn't have attributed her trauma to a given religion while

discussing the case with others.

 

<<<Maybe you would have just called her a liar, as you *seem* to be

calling me.>>>

 

I'm not calling you a liar. I'm saying it was inappropriate to

mention the religions she named when discussing the case. As I am

familiar with these religions, I also know that the events described

are *not* part of their practices, but others reading these post may

not. Furthering a negative point of view regarding a religion or

religions is of little use to anyone. A little sensitivity goes a

long way.

 

<<<Oh, and don't try to say that religious experience is not related

to holistic medicine.>>>

 

I didn't. Any experiences, religious or otherwise, that affect a

patient's medical state are relevant, the names of the religion

attributed to the events are not.

 

<<<If we are going to be politically correct, we aren't going to be

anything *but* politically correct.>>>

 

Clearly, you're missing the point. You could have mentioned every

instance of trauma contributing to the patient's condition, without

pointing fingers at a given religion as being responsible for the

trauma.

 

 

Regards,

 

Andrea