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January 15, 1999
APA and allies from other psychiatric organizations cosponsored several resolutions that were approved by the AMA House of Delegates (HOD) at the HOD's interim meeting in Honolulu last month.
APA joined with the American Academy of Child and Adolescent Psychiatry (AACAP) in cosponsoring a resolution opposed to the creation of a national patient identifier.
Resolution 207, which was presented in the AMA Reference Committee on Legislation (B), was approved by the House of Delegates as reaffirmation of existing policy.
The resolution asked the AMA to "strongly support legislation to repeal the requirement for a standard national patient identifier for all Americans under the Health Insurance Portability and Accountability Act of 1996" and to also "oppose any new federal legislation or regulation that would establish a standard national patient identifier."
In July APA President Rodrigo Muņoz, M.D., wrote Senator Patrick Leahy (D-Vt.) offering support for legislation Leahy introduced that would repeal the authorization for a national patient identifier. "We believe the development of the national patient identifier both endangers individual liberty and privacy and would also undermine the confidentiality of the doctor-patient relationship that is so necessary for quality medical care," Muņoz wrote. The establishment of such an identifier would make it "much easier for many agencies of government, including law enforcement, to gain access to our most personal medical information," he noted.
APA's effort was mirrored by the AMA two weeks later when AMA Executive Vice President E. Ratcliffe Anderson Jr., M.D., wrote Rep. Steve Chabot (R-Ohio), urging Chabot to support a proposed amendment to the Labor-Health and Human Services-Education Appropriations bill that would bar spending funds to establish a national patient identifier. Anderson wrote that the "imposition of a unique patient identifier may pose an extraordinary threat to individual privacy." In June 1998 the AMA House of Delegates declined support for such an identifier "unless and until their necessity and safety are more convincingly demonstrated," Anderson observed.
In May APA Vice President Richard Harding, M.D., testified for APA before a Congressional subcommittee concerned with medical record confidentiality (Psychiatric News, June 19, 1998; October 16, 1998). At that time Harding commented that anything that threatens the confidentiality of doctor-patient communication "impairs the ability of a psychiatrist to help his or her patient and may cause the patient to stop receiving medical care."
Aresolution on research on violence in school settings was adopted. Resolution 403, which came from the Reference Committee on Public Health (D), was drafted by the American Academy of Child and Adolescent Psychiatry (AACAP) and cosponsored by APA and the American Academy of Pediatrics. It asked that the AMA "work with all appropriate specialty societies to review the existing scientific literature concerning the incidence and causes of violence in school settings. . . ."
The resolution also asked the AMA to work with the appropriate specialty societies to review evidence on the impact of media reporting of violence and to review the research on the efficacy of school-based violence-prevention programs. During testimony at the House of Delegates, the AMA Council on Scientific Affairs (CSA) expressed its willingness to undertake the reviews as directed in the resolution. The reference committee also suggested that the CSA consider including educators, school nurses, and other nonphysicians in the requested studies. A related measure supporting evaluation by psychiatrists of children who bring guns to school also won overwhelming approval in the HOD (Psychiatric News, January 1).
The American Association of Geriatric Psychiatry helped the American Geriatrics Society draft a resolution discouraging the use of restraints in elderly patients. Resolution 516 from the Reference Committee on Science and Technology was adopted by the HOD without debate.
The text of the resolution notes the many problems associated with use of restraints and that their use is contrary to the goal of helping the elderly to function as independently and with the highest quality of life possible. It further notes that increased attention to patient needs may reduce the need for use of restraints.
It asked that the AMA Board of Trustees work "in conjunction with state and local medical societies and all appropriate specialty organizations to review existing restraint guidelines, encourage use of existing resources to promote professional caregiving staff education, and encourage and support research into individualized methods to respond to patient safety needs in all patient care settings."