At the Special Meeting of its House of Delegates, the American Medical Association (AMA) said it will urge the federal government to revise the definition of harm to include mental and emotional distress, making the definition more flexible for physicians who have been constrained by rules that limit the definition to physical events.
Under current regulations, physicians must release health information even when – in their professional judgment – they believe that doing so would emotionally or psychologically harm their adolescent patient. Physicians treating adolescents must share sensitive information to parents or patients’ proxies in sensitive areas such as reproductive health, mental health or substance use. While sharing that information might not result in physical harm to the adolescent, it could result in severe mental anguish or emotional distress as the patients deals with the reaction from their family member.
Pediatricians and other clinicians who provide care for children and adolescents are stewards of that information and should be granted discretion when they are concerned about the consequences on the child.
“The current regulation that permits a physician to withhold the release of information in cases of anticipated physical harm is a blinkered view of the patient-physician relationship. It denies physicians their ability to exercise their expertise and training to evaluate the needs of a patient,” said AMA Board Chair-elect Bobby Mukkamala, M.D. “Adolescents trust their physicians to guide them through difficult times. This change would build stronger trust.”
The AMA will urge the HHS Office for Civil Rights to revise the definition to include mental and emotional distress. That would give physicians flexibility under the Preventing Harm Exception – based on their professional judgment – to withhold sensitive information they believe could cause physical, mental or emotional harm to the patient.
The AMA also will ask the Office for Civil Rights to assemble a commission of medical professionals to help the office review the definition of harm and provide scientific evidence demonstrating that mental and emotional health is intertwined with physical health.
