![]() If you are prescribing an opiate, it is ethically reasonable (and now the law) for you to make writing the prescription contingent on your patient agreeing to your consulting the registry. Almost all states now have prescription registries to help detect doctor shopping, multiple prescribers, and misdirection. Opiate addiction has quadrupled in the past 15 years. But, the primary basis for these decisions should be a commitment to patient advocacy and to common sense, which in this situation means, “Would the typical reasonable person be upset if she learned I had done something without telling her?” If the answer to that question is yes, or in any way equivocal, I think ethics would dictate obtaining consent or at least assent. ![]() The judiciary reserves the power to intervene, so medical custom should be informed by laws and by legal principles. ![]() In my opinion, most of what is and isn’t permissible is determined by medical custom and not by statutes. Mom is a Hollywood celebrity and, while reviewing her chart, prurient curiosity extends the search to records of her cosmetic surgeries.State laws and hospital policies will vary. Access to mental health records involving addiction treatment requires special authorization.The criteria for selecting which mothers’ charts to review involve racial profiling.Reviewing the mother’s chart may be problematic if: One sensitive situation arises when a pediatrician is concerned that the newborn is at risk for opiate withdrawal. PowellNormally, that review is not problematic.
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