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Confidentiality challenges surrounding plasma therapy during the COVID-19 pandemic: a case discussion in Iran

Abstract

Maintaining confidentiality, both in national and international codes of ethics, is considered an important principle in healthcare and the medical profession for both patients and physicians. This case-report article focused on a real case. Based on the request of the Iranian Blood Transfusion Organization (IBTO) for plasma donation from recovered COVID-19 patients, we asked the names and personal information of those patients from hospitals affiliated with Iran University of Medical Sciences (IUMS) and arranged for the subjects to be referred to the Medical Ethics Department of IUMS for consultation during the COVID-19 pandemic. Various ethical and legal aspects of this case were discussed in a special meeting, and practical solutions were then provided considering the limits of confidentiality and conditions for ethical access to patients’ information during a pandemic.
Since plasma therapy is not a definitive cure for COVID-19 and considering the ethical and legal points presented in this article, it is not recommended to announce the names of patients in the early stages. Given the potential impacts of the procedure and the possibility of patients being cured, however, their consent should be obtained in different situations and, if necessary, providing information to patients or educating them should be considered.

Imran M, Samad S, Maaz M, Qadeer A, Najmi AK, Aqil M. Hippocratic oath and conversion of ethico-regulatory aspects onto doctors as a physician, private individual and a clinical investigator. J Midlife Health. 2013; 4(4): 203-209.

Ryan CJ, Callaghan S, Large MM. Communication, confidentiality and consent in mental health care. Med J Aust. 2014; 200(1): 9.

Tavaokkoli SN, Nejadsarvari N, Ebrahimi A. Analysis of medical confidentiality from the islamic ethics perspective. J Relig Health. 2015; 54(2): 427-34.

Page K. The four principles: can they be measured and do they predict ethical decision making? BMC Med Ethics. 2012; 13: 10.

Saeedi Tehrani S, Madani M. Bioethical principles and medical futility. Medical Ethics and History of Medicine. 2015; 7(6) :1-14. [in Persian]

Asemani O, Ebrahimi S. Medical confidentiality. Medical Ethics and History of Medicine. 2014; 6(6): 64-76. [in Persian]

Sankar P, Mora S, Merz JF, Jones NL. Patient perspectives on medical confidentiality: a review of the literature. J Gen Intern Med. 2003;18(8): 659-69.

Hardiman M, Edwards T. Clarifying the confusion about HIPAA-compliant texting. [cited 2020 December]; available from: https://www.perfectserve.com/wp-content/uploads/2017/11/HIPAA-compliant-texting-White-Paper.pdf

Josefson D. New rules announced on confidentiality of US patient records. BMJ. 2002; 325(7361): 408

Gershon AS, Tu JV. The effect of privacy legislation on observational research. CMAJ. 2008; 178(7): 871-3.

Anonymous. The personal information protection and electronic documents act (PIPEDA). [cited 2020 December]; available: https://www.priv.gc.ca/en/privacy-topics/privacy-laws-in-canada/the-personal-information-protection-and-electronic-documents-act-pipeda/

Thorogood A. Canada: will privacy rules continue to favour open science? Hum Genet. 2018; 137(8): 595-602.

Milanifar A, Larijani B, Paykarzadeh P, Ashtari G, Akhondi MM. Breaching confidentiality: medical mandatory reporting laws in Iran. J Med Ethics Hist Med. 2014; 7: 13.

Etemadi A, Sadjadi A, Semnani S, Nouraie SM, Khademi H, Bahadori M. Cancer registry in Iran: a brief overview. Arch Iran Med. 2008; 11(5): 577-80.

Noroozi M, Zahedi L, Bathaei FS, Salari P. Challenges of confidentiality in clinical settings: compilation of an ethical guideline. Iran J Public Health. 2018; 47(6): 875-83.

Nazari Tavakoli S, Nejadsarvari N. Confidentiality: a comparative study between medical ethics principles and Islamic ethics. Medical Ethics and History of Medicine. 2013; 5(7): 40-54. [in Persian]

Yarmohammadian MH, Raeisi AR, Tavakoli N, Nansa LG. Medical record information disclosure laws and policies among selected countries; a comparative study. J Res Med Sci. 2010; 15(3): 140-9.

Kadivar M, Jannat Makan Z. Moral dilemmas and realistic vision in the field of health with regard to confidentiality. Medical Ethics and History of Medicine. 2014; 6(6): 56-63. [in Persian]

Salazar E, Perez KK, Ashraf M, et al. Treatment of coronavirus disease 2019 (COVID-19) patients with convalescent plasma. Am J Pathol. 2020; 190(8): 1680-90.

Salazar E, Christensen PA, Graviss EA, et al. Treatment of coronavirus disease 2019 patients with convalescent plasma reveals a signal of significantly decreased mortality. Am J Pathol. 2020; 190(11): 2290-303.

Hung IFN, To KKW, Lee CK, et al. Hyperimmune IV immunoglobulin treatment: a multicenter double-blind randomized controlled trial for patients with severe 2009 influenza A(H1N1) infection. Chest. 2013; 144(2): 464–73.

Stockman LJ, Bellamy R, Garner P. SARS: systematic review of treatment effects. PLoS Med. 2006; 3(9): e343.

Cheraghali A M, Abolghasemi H, Eshghi P. Management of COVID-19 virus infection by convalescent plasma. Iranian Journal of Allergy Asthma and Immunology. 2020; 9(Supple.1): 3-6.

Wooding DJ, Bach H. Treatment of COVID-19 with convalescent plasma: lessons from past coronavirus outbreaks. Clinical Microbiology and Infection. 2020; 26(10): 1436-46.

Islam A, Rafiq S, Karim S, Laher I, Rashid H. Convalescent plasma therapy in the treatment of COVID-19: practical considerations: correspondence. Int J Surg. 2020; 79: 204-5.

Madani M. Ethical considerations of futile care. Medical Ethics and History of Medicine. 2013; 6(2): 31-42. [in Persian]

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IssueVol 13 (2020) QRcode
SectionSupplement
DOI https://doi.org/10.18502/jmehm.v13i27.5044
Keywords
Confidentiality; Confidentiality breach; COVID- 19; Plasma therapy.

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How to Cite
1.
Saeedi Tehrani S, Hashemi A, Madani M, Forouzandeh M. Confidentiality challenges surrounding plasma therapy during the COVID-19 pandemic: a case discussion in Iran. J Med Ethics Hist Med. 2020;13.