What is a Release of Information?

HIPAA compliant Releases must be honored within 10 days, except as prohibited by applicable state law. 
(See Berg v Berg, and Wolowitz.)

8 elements of a good HIPAA compliant release:

1. Name and specific identification of patient, DOB
2. Parties exchanging information are listed
3. Direction of Releases specified as to or from
4. Scope of information to be disclosed
5. Purpose for disclosure
6. Expiration or end date for disclosure
7. Statement of permission as freely given without coercion
8. Revoke or refusal option, noting exemption for information legally disclosed before revocation date.
9. Signature, date, relationship to patient

You may discuss the release with your patient so that they understand the scope and impact of the disclosure. 

What about a Subpoena?

Respond - but how?  Call your supervisor - always!

Although a response is needed within the legal process, your full and immediate compliance with the request may place you in legal and ethical jeopardy - so Check with supervision and an attorney, especially if you foresee conflicts about what may be disclosed - conflicts between people, and within your clinical and professional ethical values.

Consider first: Does this disclosure serve your patient's needs? 

•  Safety?
•  Nurturance?
•  Will it extend an illusion of coercion and control by the adversary that is inappropriate or unsafe?
•  Will it compromise their privacy in therapy?
•  Have they said things in therapy to explore ambivalence that could offend the parties of the adversary?
•  Will this put a damper on their future freedom in therapy?
•  Will this impact future motivation in therapy to manipulate or conceal information, or process their issues according to a particular slant?

What about a Court Order?

A court order is very important, yet still is subject to human limitations in understanding and knowledge of systems and professional boundaries.  If you are ordered to perform an action that is contrary to professional conduct or patient well-being, immediately seek supervision and your agency's legal advice.

Your Thoughts - important input

So, what if you believe you are being asked to share information that is not in the best interests of your patient?

Reviewing the above questions and your understanding of the case, seeking supervision, and reviewing the facts, will help you to sort out what you believe to be most important factors in dealing with the disclosure challenge.  Writing this into a succinct narrative can greatly help your attorney address the arguments in an effective way to facilitate you through this process.