By Ryan Pferdehirt, D.Bioethics, HEC-C

June 2021

HIPAA Rights and Patient Privacy Bioethics Case Study

Skyler is a 33-year-old female, who is 38.5 weeks pregnant and came to the hospital in labor. When she presented to the hospital, Skyler was given the standard admission paperwork, and signed without any questions or issues (although was in considerable distress due to active labor and did not have anyone else at the hospital with her). The patient is relatively well known to the hospital, having presented several times due in fact to her history of drug and substance abuse.

Due to standard procedure, visual assessment, and the patient’s history, the medical team requested Skyler give a urine sample for a drug screen. The patient is actively refusing to participate, stating the hospital has no right to know one way or another. The patient cites HIPAA as a reason. It was then explained that another drug screen will be performed on the infant after birth.  Now Skyler is choosing to leave against medical advice (AMA). Due to the clinical and emotional distress the patient is in and risk to the infant if her drug screen was positive, the medical team is not sure if it is ethically permissible to allow Skyler to leave.

The medical team requests an ethics consult.