CLINICAL ETHICS

Privacy and patient–clergy access: perspectives of patients admitted to hospital

E Erde¹, S C Pomerantz², M Saccocci¹, V Kramer-Feeley² and T A Cavalieri²

¹ Department of Family Medicine, School of Osteopathic Medicine, University of Medicine and Dentistry of New Jersey, Stratford, New Jersey, USA
² Department of Medicine, School of Osteopathic Medicine

Correspondence to:
Correspondence to:
Dr Sherry C Pomerantz
Department of Medicine, School of Osteopathic Medicine, University of Medicine and Dentistry of New Jersey, University Doctors Pavilion Suite 3100, 42 East Laurel Road, Stratford, NJ 08084, USA; Sherry.Pomerantz{at}umdnj.edu

Background: For patients admitted to hospital both pastoral care and privacy or confidentiality are important. Rules related to each have come into conflict recently in the US. Federal laws and other rules protect confidentiality in ways that countermand hospitals’ methods for facilitating access to pastoral care. This leads to conflicts and poses an unusual type of dilemma—one of conflicting values and rights. As interests are elements necessary for establishing rights, it is important to explore patients’ interests in privacy compared with their desire for attention from a cleric.

Aim: To assess the willingness of patients to have their names and rooms included on a list by religion, having that information given to clergy without their consent, their sense of privacy violation if that were done and their views about patients’ privacy rights.

Methods and participants: 179 patients, aged 18–92 years, admitted to hospital in an acute care setting, were interviewed and asked about their preferences for confidentiality and pastoral support.

Results: Most (57%) patients did not want to be listed by religion; 58% did not think hospitals should give lists to clergy without their consent and 84% welcomed a visit by their own clergy even if triggered from a hospital list.

Conclusions: Values related to confidentiality or privacy and pastoral care were found to be inconsistent and more complicated than expected. Balancing the right to privacy and the value of religious support continue to present a challenge for hospitals. Patients’ preferences support the importance of providing balance in a way that protects rights while offering comprehensive services.

Abbreviations: HIPAA, Health Insurance Portability and Accountability Act; JCAHO, Joint Commission for the Accreditation of Health Care Organizations

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