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Slate's Explainer: Doctors and the Press

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In Jerusalem, an array of international media and ordinary citizens are gathered outside Hadassah Hospital, waiting for updates on the health of Prime Minister Ariel Sharon. Josh Levin of Slate explains how much information doctors can reveal about their patients' conditions to the media.

MADELEINE BRAND, host:

Every day we receive updates on Sharon's health from his doctors. Here in America doctors are also revealing details about the progress of the only survivor from last week's mine disaster in West Virginia. Yesterday they said Randall McCloy is showing signs of brain activity. But where does our right to know end and McCloy's right to privacy begin? Is there any private medical information the hospital cannot release? The Explainer team from the online magazine Slate is on the case. And Slate's Josh Levin has the answer.

JOSH LEVIN:

Under federal privacy rules, doctors can reveal only the most general information about a patient, what's called directory information. They can confirm that a specific patient has been admitted to the hospital. And they can give a short assessment of his overall condition. Assessments are often just one word: good, fair, serious or critical. If a patient is conscious and alert when he comes into the hospital, he's given the option to keep even this general information under wraps. A patient can also forego his privacy protections. He can give the hospital free rein to discuss his case by preparing a formal authorization letter that explains which information will be disclosed and to whom. If a patient is incapacitated, like Randall McCloy, and can't make decisions about his own privacy, those decisions fall to his next-of-kin. McCloy's doctors begin discussing his case only after receiving written permission from his wife.

What do those one-word condition assessments really mean? Each hospital comes up with its own rules. But most are derived from the standards published by the American Hospital Association. Patients in good condition should be conscious and comfortable. Patients in fair condition are conscious but may be uncomfortable. A case is considered serious if the patient is acutely ill, and critical if their vital signs are unstable and not within normal limits. A final note on death: Hospitals may disclose a patient's death as a general condition assessment but they may not give out the time, date or cause of death without permission.

BRAND: Josh Levin is an editor at Slate, and that Explainer was compiled by Daniel Engber.

NPR's DAY TO DAY continues. I'm Madeleine Brand.

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