title: Disclosure of personal medical information: differences among parents and affected adults for genetic and nongenetic conditions.
abstract: Protecting the confidentiality of medical information has been an issue of great interest in the fields of bioethics, public policy, and law. Few empirical studies have addressed patient experiences and attitudes toward disclosure of private medical information in multiple contexts such as health insurance, employment, and the family. Furthermore, it is unclear whether differences exist in experiences and attitudes about privacy between those living with a serious medical condition versus those who have a child with a medical condition. The study sought to determine whether attitudes and experiences related to medical privacy and confidentiality differ between affected adults and parents of affected children. Interviews were conducted with 296 adults and parents of children with sickle cell disease (SCD), cystic fibrosis (CF), or diabetes mellitus (DM). This cross-sectional study collected data regarding their experiences, attitudes, and beliefs concerning medical privacy and confidentiality. Multinomial logistic regression analysis was conducted on quantitative data. Qualitative analysis was conducted on data from open-ended response items. Parents disclose their child's diagnosis to others more often than affected adults disclose their own disease status. Parents are less likely than affected adults to regret their disclosure, to hope others do not find out, to have been pressured to share information, and to be asked about their disease by employers. Affected adults express greater concern about disclosure, a greater prevalence and greater fear of discrimination, and experience greater pressure from family members to disclose. Clinicians and researchers working with these populations should consider these differences in privacy and disclosure. Further study is necessary to examine the implications of these differences in attitudes and experiences concerning insurance, employment, and social interactions among persons with these conditions.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, Maryland 21205, USA. sjohnso2@jhsph.edu
authors.forename: Summer
authors.initials: S
authors.lastname: Johnson
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Kass
authors.forename: Marvin
authors.initials: M
authors.lastname: Natowicz
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell; D001675:Bioethics; D002648:Child; D003219:Confidentiality; D003550:Cystic Fibrosis; D003920:Diabetes Mellitus; D030881:Disclosure; D006801:Humans; D016015:Logistic Models; D008499:Medical Records; D010290:Parents; D018907:Privacy