Privacy, publicity and security: the American context. Privacy is not only a right but also an obligation.
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This study which was based on hermeneutic phenomenology, investigated how paid caregivers in two nursing homes experienced older residents' sexuality. Caregivers acknowledged there were obstacles to residents fulfilling their sexual desires. The medical model of care still largely determines the norms and values within nursing homes and governs the actions of staff. Sexuality within the current medical model is not considered to be part of the primary caregiving role because sexuality is not deemed to play a vital role in the maintenance of bodily functions. Because they are geared toward the demands of basic body care, nursing homes are not inclined to create an environment conductive to the fulfillment of sexual needs.
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Because medical records are now more comprehensive than ever before, they increasingly are being demanded for uses both inside and outside of the medical profession. Mr. Gellman contends that existing ethical and legal guidance is inadequate to aid physicians in dealing with the confidentiality issues raised when patient information is requested or demanded from them, and supports this contention by examining the dilemmas faced by physicians presented with such requests or demands. He concludes that ethical and judicial guidance will continue to be inadequate, and that the only practical way to develop suitable guidance is through legislation.
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The Department of Health and Human Services is amending system of records 09-90-0024 to add new routine uses for the purpose of collecting debts owed the Federal Government, and to add a disclosure to consumer reporting agencies as authorized by 5 U.S.C. 552a(b) (12) as added by the Debt Collection Act of 1982 (Pub. L. 97-365). A number of other amendments have been made to reflect changes of organization and titles. We invite public comment on these routine uses.