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Forget doctor-patient privilege: Army demands medical files
If you're enlisting, don’t expect doctor-patient privilege – new IDF order allows army to access patient files, directly from healthcare provider. Doctors warn, ‘It’s an ethical issue’. Army insists, ‘For good of soldiers’
Planning to hide your asthma to serve in the army? Did you intend to get confirmation of your back problems in order to avoid combat service? You should think again. The IDF already knows everything about you, even before you get your first draft notice.

 

In April, the IDF launched project Complete Information, and within its framework, the army receives all significant medical information on potential enlistees, directly from their HMO, without asking the permission of the recruit.

 

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Until now, candidates were expected to provide their own medical information – a procedure which allowed them to leave out what they wanted to keep private, or alternatively, to provide information to lower or raise their combat service profile.

 

According to the IDF, the purpose of the new project is two-fold: ensuring that the IDF receives complete, reliable information on health issues of those joining up, and allowing better continuity of care. Additionally, the IDF will more easily be able to identify those who lie for reasons of excessive motivation or lack of motivation to serve.

 

Patient-doctor privilege? It causes problems

"Epileptics cannot serve at sea, and young adults with severe asthma cannot serve in the infantry. We want to know how to more appropriately assign the soldiers in units, how not to endanger him or aggravate a medical condition," explained Colonel Dov Albukerk, a doctor, and commander of medicine for the Central Command.

 

“Until now the potential recruit relayed the medical information from the HMO, which created a lot of problems. It demanded full responsiveness, which was not always there. There were barriers of language and understanding, and we could not tell if it was really his family doctor who signed the information, or a relative who is also a doctor. So only 50 to 60 percent of the forms were filled out, and we received incomplete information," he said.  

 

According to the new procedure, the army provides the identity number of the potential recruits, and received the medical files from the HMOs. This gives them all the significant medical information: chronic diseases, medications taken regularly, drug sensitivities and relevant family history. The information is sent to the military doctor, who then checks the suitability of the potential recruit. Via this new method, the army hopes to reduce the dropout rates from IDF combat units due to medical reasons.

 

"We understand that this is a matter of medical confidentiality, but we in the IDF have a responsibility for these soldiers, "said Colonel Albukerk. "The transition from civilian life to the Medical Corps is our central challenge in terms of maintaining a continuity of information and health care."

 

He added that the IDF relies on a patient bill of rights, which is claimed to be the best way to maintain continuity of care. "When a person moves to another HMO, the previous HMO must transfer their files. The Medical Corps is a soldier's insurer, thus the files comes to us," he explained.

 

Civilian doctors appeared less enthusiastic about the project. "This is a major problem," said Prof. Avinoam Reches, chairman of the ethics board of the Israel Medical Association, adding that the issue will soon be debated at the ethics office.

 

"I'm afraid that this way, the boy who is about to enlist will even hide the information from his family doctor. If he had an epileptic fit a half year before the first draft notice, I would not be surprised if he refrains from telling his doctor about it," Reches said. "The medical record belongs to the patient, not the HMO, and the boy did not sign a consent form stating that the IDF could see his file."

 

 

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פרסום ראשון: 08.02.13, 14:18
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