ABSTRACT
The authors address the legal void that exists regarding medical student access to clinical records and health information that local healthcare organizations hold under legal and institutional custody. They develop a legal thesis that configures the creation of medical student professional secrecy and its connection with the duty of confidentiality as assumptions that underlie the medical student's right to access and reuse health information. Medical students have the legitimacy to access health information and clinical records, as they bear an unequivocal informational, legitimate, constitutionally protected and sufficiently relevant need. They conclude that the legislature must work together with universities and hospital institutions to legally establish the concept of Medical Student Professional Secrecy, its link to the duty of confidentiality and the right of the medical student to access and reuse health information. Furthermore, it must do so in a specific legal act and in the precise terms of the text approved unanimously by the Council of Portuguese Medical Schools, by the National Council of Medical Ethics and Deontology, by the National Council of the Portuguese Medical Association and by its President.
Os autores abordam o vazio legal que existe, no acesso, por parte de estudantes de medicina, aos registos clínicos, à informação de saúde, na posse e à guarda legal e institucional das unidades de saúde. Por outro lado, desenvolvem uma tese jurídica que configura a criação do segredo do estudante de medicina e a sua vinculação ao dever de sigilo, como pressupostos que fundamentam o direito do estudante de medicina em aceder e reutilizar informação de saúde. O estudante de medicina tem legitimidade para aceder a informação de saúde, a registos clínicos, já que é inequívoco ser portador de uma necessidade informacional, legítima, constitucionalmente protegida e suficientemente relevante. Concluem, que o poder legislativo se associe às instituições, universitárias e hospitalares, instituindo, por diploma legal, o Segredo do Estudante de Medicina, a sua vinculação ao dever de sigilo e o direito do estudante de medicina em aceder e reutilizar informação de saúde. E deve fazê-lo, em diploma específico, nos precisos termos do texto aprovado, por unanimidade, pelo Conselho das Escolas Médicas Portuguesas, pelo Conselho Nacional de Ética e Deontologia Médicas, pelo Conselho Nacional da Ordem dos Médicos e pelo Bastonário da referida Ordem.
Subject(s)
Access to Information/legislation & jurisprudence , Confidentiality/legislation & jurisprudence , Health Records, Personal , Schools, Medical/legislation & jurisprudence , Students, Medical/legislation & jurisprudence , Education, Medical/legislation & jurisprudence , European Union , Health Facilities/legislation & jurisprudence , Humans , PortugalABSTRACT
Abiding to the law is, in some cases, a delicate balance between the rights of different players. Re-using health records is such a case. While the law grants reuse rights to public administration documents, in which health records produced in public health institutions are included, it also grants privacy to personal records. To safeguard a correct usage of data, public hospitals in Portugal employ jurists that are responsible for allowing or withholding access rights to health records. To help decision making, these jurists can consult the legal opinions issued by the national committee on public administration documents usage. While these legal opinions are of undeniable value, due to their doctrine contribution, they are only available in a format best suited from printing, forcing individual consultation of each document, with no option, whatsoever of clustered search, filtering or indexing, which are standard operations nowadays in a document management system. When having to decide on tens of data requests a day, it becomes unfeasible to consult the hundreds of legal opinions already available. With the objective to create a modern document management system, we devised an open, platform agnostic system that extracts and compiles the legal opinions, ex-tracts its contents and produces metadata, allowing for a fast searching and filtering of said legal opinions.
Subject(s)
Access to Information , Attitude , Electronic Health Records , Privacy , Data Mining , Humans , PortugalABSTRACT
PURPOSE: Recognizing the relevance of mental pain in drug addiction, this study aimed to adapt and validate the Portuguese translation of the Orbach & Mikulincer Mental Pain Scale (OMMP) on a drug addicted population and assess its psychometric properties. METHODS: The study sample (N = 403) was collected from several outpatient treatment centres for drug addiction and in therapeutic communities located in the north of Portugal. The validation of the OMMP Scale followed the same method considered by the authors of the original scale. RESULTS: A confirmatory factor analysis (CFA) was performed and did not confirm the structure of eight factors provided by the authors. An exploratory factor analysis revealed a five-factor model (labeled emptiness, irreversibility, emotional flooding, helplessness and confusion) leading to a reduction from 40 to 24 items. The OMMP-24-P showed acceptable levels for internal consistency and test-retest reliability. Confirmatory factor analysis indices supported the five-factor model. OMMP-24-P factors were positively correlated with measures of stress, anxiety and depression, negatively associated with quality of life, and showed small to moderate positive correlations with drug addiction severity, with exception of the helplessness factor. CONCLUSIONS: This study has shown the OMMP-24-P to be a valid and reliable scale for assessment and evaluation of mental pain among drug addicts. Further research should attempt to determine the contribution that mental pain can provide towards an understanding of drug addiction dynamics and other psychopathological syndromes, and thereby contribute to the development of more effective treatment programs.
