[Med-privacy] Legal Times: A Tale of Privacy Woe by James Pyles March 14, 2005
DPeelMD@aol.com
DPeelMD@aol.com
Wed, 30 Mar 2005 01:10:22 EST
-------------------------------1112163022
Content-Type: text/plain; charset="UTF-8"
Content-Transfer-Encoding: quoted-printable
Content-Language: en
This tale is a response to Senator Frist's recent article in JAMA. The Lega=
l=20
Times wanted a response from the lead attorney in the federal lawsuit to =20
restore the right of consent.
Deborah Peel, MD
_www.patientprivacyrights.org_ (http://www.patientprivacyrights.org) =20
PLEASE make a tax-deductible contribution to fund the federal appeal via=20
this website. We need your help!
WEEK OF MARCH 14, 2005 =E2=80=A2 VOL. XXVIII, NO. 11=20
A Tale of Privacy Woe=20
If protection of medical data isn=E2=80=99t strengthened, the future may be=
bleak.=20
BY JAMES C. PYLES=20
Arecent article in a respected medical journal by a certain prominent=20
senator from the state of Tennessee set forth the medical treatment that mi=
ght be=20
provided to a hypothetical individual in the year 2015. The article describ=
ed=20
how this individual avoided an impending heart attack while traveling becau=
se=20
his entire medical record was available to nearly every emergency room in=20
the United States, with his permission, under an electronic national health=
=20
information network.=20
The following scenario sets forth a different hypothetical set of facts=20
under an electronic national health information network based on the Health=
=20
Information Privacy Rule put into effect approximately 20 months ago.=20
This scenario is considerably less positive, but it illustrates =20
realistically that medical privacy is essential for quality government as we=
ll as quality=20
health care.=20
SKELETONS UNEARTHED=20
Sen. Fernlund Farnsworth from the hypothetical state of Columbia decides in=
=20
the year 2015 that his many years of experience in the Senate and his =20
training as a medical doctor would make him a strong candidate for the pres=
idency in=20
2016.=20
After he makes his intentions known, he is visited by a representative of=20
the health insurance industry, who presents him with a list of legislative=20=
and=20
administrative measures that the industry desires to have passed and=20
implemented if the senator is elected.=20
Being highly principled, the senator states that he will consider the=20
measures, but can make no promises.=20
The insurance industry representative states that it would be in the senato=
r=E2=80=99
s best interest to commit to supporting these measures because, otherwise,=20
certain embarrassing information in his medical history could come to light=
.=20
Outraged, the senator invites the representative to leave his office.=20
Several months later, as the senator is heavily involved in securing his=20
party=E2=80=99s nomination, he receives telephone calls from two national n=
ewspapers.=20
They alert him that in the next several days they plan to run articles stat=
ing=20
that the senator received treatment and medication for depression and had=20
even briefly considered suicide during that summer after college, when he f=
elt=20
"lost."=20
As he hangs up the telephone, the senator wonders how the newspapers could=20
have gotten possession of such intensely personal health information from s=
o=20
long ago.=20
Then he remembers the veiled threat from the health insurance =20
representative.=20
He also suddenly remembers that the Health Information Privacy Rule that=20
took effect April 14, 2003, expressly authorized the use and disclosure of=20
virtually all health information to covered entities (including health insu=
rers)=20
and their business associates for routine purposes. No permission from the=20
patient is required, consumers are not entitled to notice, and no accountin=
g of=20
the uses of the medical information is mandated.=20
He recalls that the rule was retroactive and applied to any health =20
information created since the beginning of time. He remembers that the Natio=
nal =20
Electronic Health Information System legislation that he helped enact in 200=
5 =20
incorporated the principles of the Health Information Privacy Rule.=20
To his dismay, he recalls that in a hearing before a Senate committee on=20
which he served in April 2002, he had supported an amendment to the origina=
l=20
Health Information Privacy Rule that eliminated the patient=E2=80=99s right=20=
of consent=20
for the use and disclosure of identifiable health information in routine =20
situations.=20
He also remembers, with growing discomfort, that his staff had been informe=
d=20
after the hearing that the Tennessee Supreme Court had issued a decision th=
e=20
prior month in Givens v. Mullikin (2002). The Court held that the implied=20
contract between all patients and their physicians includes a condition tha=
t=20
information obtained during the physician-patient relationship will not be=20
released without the patient=E2=80=99s permission.=20
He now begins to realize the wisdom of the holding in Givens.=20
He also recalls the principle contained in the Hippocratic oath, which he=20
took upon graduation from medical school, as well as the ethics standards o=
f=20
the American Medical Association that prohibit the use and disclosure of a=20
patient=E2=80=99s health information without the patient=E2=80=99s consent.=
=20
In a frantic effort to save his political career, Farnsworth files a lawsui=
t=20
in federal court seeking to enjoin the publication of his personal health=20
information. The court refuses to grant the injunction based on the 2001 =20
Supreme Court decision in Bartnicki v. Vopper, which held that the media ha=
ve a=20
First Amendment right to publish information about a matter of public inter=
est,=20
even if the information was revealed unlawfully by a third party.=20
The newspapers publish the account of the senator=E2=80=99s treatment for d=
epression=20
corroborated by detailed information from his medical records, including=20
when and where the treatment occurred, the types of anti-depressant medicat=
ions=20
prescribed, and how long he took them.=20
His approval ratings in the polls plummet, and he drops from a front-runner=
=20
in the campaign to being hopelessly out of contention.=20
He now clearly understands the potential for widely accessible personal=20
health information to be used as a political weapon, which he had only vagu=
ely=20
understood before.=20
CHILLING DISCLOSURE=20
Determined to protect his family from suffering the type of humiliation tha=
t=20
he has endured, he warns his wife and daughter against providing health=20
information about themselves that could be harmful if disclosed. His wife t=
hen=20
postpones for more than a year a screening test for the so-called breast ca=
ncer=20
gene until, suddenly, she is diagnosed with breast cancer. His daughter=20
delays telling her doctor about a sexually transmitted disease she has cont=
racted=20
until it leaves her sterile.=20
Farnsworth now painfully realizes the validity of the findings of the=20
Department of Health and Human Services that more than a half-million indiv=
iduals=20
each year fail to seek earlier treatment for cancer out of privacy concerns=
.=20
One-third of women who were offered a free genetic screening test for breas=
t=20
cancer by the National Institutes of Health declined to take it, citing =20
concerns about the loss of privacy and the potential for discrimination in =20=
health=20
insurance.=20
He also realizes that his daughter has become part of the statistics of=20
under-reported sexually transmitted diseases that the HHS concluded contrib=
ute to=20
fertility problems, fetal blindness, ectopic pregnancies, and other=20
reproductive disorders.=20
Even he now feels that, if he had it to do over again, he would be among th=
e=20
more than 2 million people each year, according to HHS estimates, who do no=
t=20
seek treatment for a mental illness because of privacy concerns.=20
To his distress, he also realizes that all of the department=E2=80=99s find=
ings were=20
published in the Federal Register prior to the adoption of the amended=20
Health Information Privacy Rule and enactment of the legislation creating a=
=20
national electronic health care information network.=20
Why had he not paid attention? Why had he not noted the department=E2=80=
=99s=20
findings that throughout the nation=E2=80=99s history the personal privacy =20=
rights of=20
citizens have been at the forefront of our form of constitutional democracy=
?=20
Why had he not relied on traditional standards of medical ethics and the=20
oath he had taken upon becoming a physician? Why had he not demanded that=20
protecting the individual=E2=80=99s right to medical privacy be made a princ=
ipal goal of=20
the health care legislation?=20
Could he have gotten swept up in the rush to adopt an electronic national=20
health information system on the unproven promise that it would reduce heal=
th=20
care costs?=20
SCARING PATIENTS=20
Devastated by his personal loss and disappointed in the lost opportunity to=
=20
serve his country, Sen. Farnsworth returns to private life and resumes his=20
practice as Dr. Farnsworth.=20
One day, he receives a telephone call from the wife of one of his patients,=
=20
Rodney Rogers. She says that her husband has died of a massive myocardial=20
infarction while traveling on a weekend trip several hundred miles from hom=
e.=20
When Farnsworth hears that Mr. Rogers had been experiencing chest pains for=
=20
several weeks before he died, he asks Mrs. Rogers why her husband had not=20
gone to an emergency room immediately, since nearly every health facility a=
nd=20
practitioner (and insurers and all of their business associates) in the Uni=
ted=20
States has access to his medical record.=20
His wife replies that this was precisely the problem. His employer was=20
downsizing, and he believed he would be laid off if it became known that he=20=
=20
suffered from heart disease. (Employers have access to medical records under=
the =20
current system as long as it is part of monitoring an employee benefit plan=
.)=20
As Farnsworth hangs up, he recalls that there had been growing public=20
concern for years over the loss of personal privacy.=20
One of the principal reasons for that concern was the increasing use of=20
interconnected electronic information systems. He knows that concern is =20
well-founded because cyber incidents and attacks have been increasing at an=20=
alarming=20
rate.=20
The federal government has never been able to assure the public that all=20
legislated privacy rights are being protected, and the federal government h=
as=20
concluded that there is no such thing as a totally secure system.=20
He realizes that the HHS was correct when it determined that "the entire=20
health delivery system is built upon the willingness of individuals to shar=
e the=20
most intimate details of their lives with their health providers."=20
For the first time, he appreciates that health information privacy is=20
essential for both a health care system and a government that are responsive=
to the=20
needs and expectations of the nation=E2=80=99s citizens.=20
With his patients increasingly refusing to confide in him, Farnsworth=20
concludes that he can no longer practice effective medicine.=20
So he retires to his farm, where he spends his remaining days berating=20
himself for not insisting in 2005 that the electronic national health infor=
mation=20
network be built foremost on the traditional ethical standard that personal=
=20
health information should not be used or disclosed without the patient=E2=
=80=99s=20
consent.=20
Sen. Farnsworth missed his opportunity. It remains to be seen whether the=20
current members of Congress will miss theirs.=20
James C. Pyles, a partner in the D.C. firm of Powers, Pyles, Sutter &=20
Verville, specializes in health law and health system reform. He currently=20
represents plaintiffs in a class action in the U.S. Court of Appeals for th=
e 3rd=20
Circuit seeking to establish a constitutional right of privacy in one=E2=
=80=99s personal=20
medical data.=20
Pyles can be reached at _jim.pyles@ppsv.com_ (mailto:jim.pyles@ppsv.com) .=20
=C2=A9 2005 ALM Properties Inc. All rights reserved. This article is reprin=
ted=20
with permission from Legal Times (1-800-933-4317 =E2=80=A2 subscriptions@le=
galtimes.com=20
=E2=80=A2 www.legaltimes.com).
-------------------------------1112163022
Content-Type: text/html; charset="UTF-8"
Content-Transfer-Encoding: quoted-printable
Content-Language: en
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
<HTML><HEAD>
<META http-equiv=3DContent-Type content=3D"text/html; charset=3DUTF-8">
<META content=3D"MSHTML 6.00.2800.1276" name=3DGENERATOR></HEAD>
<BODY id=3Drole_body style=3D"FONT-SIZE: 10pt; COLOR: #000000; FONT-FAMILY:=20=
Arial"=20
bottomMargin=3D7 leftMargin=3D7 topMargin=3D7 rightMargin=3D7><FONT id=3Drol=
e_document=20
face=3DArial color=3D#000000 size=3D2>
<DIV>This tale is a response to Senator Frist's recent article in JAMA.=
The=20
Legal Times wanted a response from the lead attorney in the federal lawsuit=20=
to=20
restore the right of consent.</DIV>
<DIV>Deborah Peel, MD</DIV>
<DIV><A=20
href=3D"http://www.patientprivacyrights.org">www.patientprivacyrights.org</A=
>=20
</DIV>
<DIV>PLEASE make a tax-deductible contribution to fund the federal appe=
al=20
via this website. We need your help!</DIV>
<P align=3Dleft>WEEK OF MARCH 14, 2005 =E2=80=A2 VOL. XXVIII, NO. 11</P><B><=
FONT=20
face=3DAkzidenzGroteskBE-Super color=3D#9a9a9a size=3D7>
<P align=3Dleft>A Tale of Privacy Woe</P></B></FONT><FONT face=3DFutura-Book=
size=3D4>
<P align=3Dleft>If protection of medical data isn=E2=80=99t strengthened, th=
e future may=20
be bleak.</P></FONT>
<P align=3Dleft>B<FONT face=3DFutura-Heavy size=3D1>Y </FONT><FONT face=3DFu=
tura-Heavy=20
size=3D3>J</FONT><FONT face=3DFutura-Heavy size=3D1>AMES </FONT><FONT=20
face=3DFutura-Heavy size=3D3>C. P</FONT><FONT face=3DFutura-Heavy=20
size=3D1>YLES</P></FONT><FONT face=3DTimes-Roman size=3D7>
<P align=3Dleft>A</FONT><FONT face=3DTimes-Roman size=3D2>recent article in=20=
a=20
respected medical journal by a certain prominent senator from the state of=20
Tennessee set forth the medical treatment that might be provided to a=20
hypothetical individual in the year 2015. The article described how this=20
individual avoided an impending heart attack while traveling because his ent=
ire=20
medical record was available to nearly every emergency room in the United=20
States, with his permission, under an electronic national health information=
=20
network.</P>
<P align=3Dleft>The following scenario sets forth a different hypothetical s=
et of=20
facts under an electronic national health information network based on the=20
Health Information Privacy Rule put into effect approximately 20 months ago.=
</P>
<P align=3Dleft>This scenario is considerably less positive, but it illustra=
tes=20
realistically that medical privacy is essential for quality government as we=
ll=20
as quality health care.</P></FONT><B><FONT face=3DUnivers-CondensedBold>
<P align=3Dleft>S</FONT><FONT face=3DUnivers-CondensedBold size=3D1>KELETONS=
=20
</FONT><FONT face=3DUnivers-CondensedBold>U</FONT><FONT face=3DUnivers-Conde=
nsedBold=20
size=3D1>NEARTHED</P></B></FONT><FONT face=3DTimes-Roman size=3D2>
<P align=3Dleft>Sen. Fernlund Farnsworth from the hypothetical state of Colu=
mbia=20
decides in the year 2015 that his many years of experience in the Senate and=
his=20
training as a medical doctor would make him a strong candidate for the=20
presidency in 2016.</P>
<P align=3Dleft>After he makes his intentions known, he is visited by a=20
representative of the health insurance industry, who presents him with a lis=
t of=20
legislative and administrative measures that the industry desires to have pa=
ssed=20
and implemented if the senator is elected.</P>
<P align=3Dleft>Being highly principled, the senator states that he will con=
sider=20
the measures, but can make no promises.</P>
<P align=3Dleft>The insurance industry representative states that it would b=
e in=20
the senator=E2=80=99s best interest to commit to supporting these measures b=
ecause,=20
otherwise, certain embarrassing information in his medical history could com=
e to=20
light. Outraged, the senator invites the representative to leave his office.=
</P>
<P align=3Dleft>Several months later, as the senator is heavily involved in=20
securing his party=E2=80=99s nomination, he receives telephone calls from tw=
o national=20
newspapers. They alert him that in the next several days they plan to run=20
articles stating that the senator received treatment and medication for=20
depression and had even briefly considered suicide during that summer after=20
college, when he felt "lost."</P>
<P align=3Dleft>As he hangs up the telephone, the senator wonders how the=20
newspapers could have gotten possession of such intensely personal health=20
information from so long ago.</P>
<P align=3Dleft>Then he remembers the veiled threat from the health insuranc=
e=20
representative.</P>
<P align=3Dleft>He also suddenly remembers that the Health Information Priva=
cy=20
Rule that took effect April 14, 2003, expressly authorized the use and=20
disclosure of virtually all health information to covered entities (includin=
g=20
health insurers) and their business associates for routine purposes. No=20
permission from the patient is required, consumers are not entitled to notic=
e,=20
and no accounting of the uses of the medical information is mandated.</P>
<P align=3Dleft>He recalls that the rule was retroactive and applied to any=20=
health=20
information created since the beginning of time. He remembers that the Natio=
nal=20
Electronic Health Information System legislation that he helped enact in 200=
5=20
incorporated the principles of the Health Information Privacy Rule.</P>
<P align=3Dleft>To his dismay, he recalls that in a hearing before a Senate=20
committee on which he served in April 2002, he had supported an amendment to=
the=20
original Health Information Privacy Rule that eliminated the patient=E2=80=
=99s right of=20
consent for the use and disclosure of identifiable health information in rou=
tine=20
situations.</P>
<P align=3Dleft>He also remembers, with growing discomfort, that his staff h=
ad=20
been informed after the hearing that the Tennessee Supreme Court had issued=20=
a=20
decision the prior month in </FONT><I><FONT face=3DTimes-Italic size=3D2>Giv=
ens v.=20
Mullikin </I></FONT><FONT face=3DTimes-Roman size=3D2>(2002). The Court held=
that=20
the implied contract between all patients and their physicians includes a=20
condition that information obtained during the physician-patient relationshi=
p=20
will not be released without the patient=E2=80=99s permission.</P>
<P align=3Dleft>He now begins to realize the wisdom of the holding in=20
</FONT><I><FONT face=3DTimes-Italic size=3D2>Givens.</P></I></FONT>
<P align=3Dleft><FONT face=3DTimes-Roman size=3D2>He also recalls the princi=
ple=20
contained in the Hippocratic oath, which he took upon graduation from medica=
l=20
school, as well as the ethics standards of the American Medical Association=20=
that=20
prohibit the use and disclosure of a patient=E2=80=99s health information wi=
thout the=20
patient=E2=80=99s consent.</P>
<P align=3Dleft>In a frantic effort to save his political career, Farnsworth=
files=20
a lawsuit in federal court seeking to enjoin the publication of his personal=
=20
health information. The court refuses to grant the injunction based on the 2=
001=20
Supreme Court decision in </FONT><I><FONT face=3DTimes-Italic size=3D2>Bartn=
icki v.=20
Vopper, </I></FONT><FONT face=3DTimes-Roman size=3D2>which held that the med=
ia have=20
a First Amendment right to publish information about a matter of public=20
interest, even if the information was revealed unlawfully by a third party.<=
/P>
<P align=3Dleft>The newspapers publish the account of the senator=E2=80=99s=20=
treatment for=20
depression corroborated by detailed information from his medical records,=20
including when and where the treatment occurred, the types of anti-depressan=
t=20
medications prescribed, and how long he took them.</P>
<P align=3Dleft>His approval ratings in the polls plummet, and he drops from=
a=20
front-runner in the campaign to being hopelessly out of contention.</P>
<P align=3Dleft>He now clearly understands the potential for widely accessib=
le=20
personal health information to be used as a political weapon, which he had o=
nly=20
vaguely understood before.</P></FONT><B><FONT face=3DUnivers-CondensedBold>
<P align=3Dleft>C</FONT><FONT face=3DUnivers-CondensedBold size=3D1>HILLING=20
</FONT><FONT face=3DUnivers-CondensedBold>D</FONT><FONT face=3DUnivers-Conde=
nsedBold=20
size=3D1>ISCLOSURE</P></B></FONT><FONT face=3DTimes-Roman size=3D2>
<P align=3Dleft>Determined to protect his family from suffering the type of=20
humiliation that he has endured, he warns his wife and daughter against=20
providing health information about themselves that could be harmful if=20
disclosed. His wife then postpones for more than a year a screening test for=
the=20
so-called breast cancer gene until, suddenly, she is diagnosed with breast=20
cancer. His daughter delays telling her doctor about a sexually transmitted=20
disease she has contracted until it leaves her sterile.</P>
<P align=3Dleft>Farnsworth now painfully realizes the validity of the findin=
gs of=20
the Department of Health and Human Services that more than a half-million=20
individuals each year fail to seek earlier treatment for cancer out of priva=
cy=20
concerns. One-third of women who were offered a free genetic screening test=20=
for=20
breast cancer by the National Institutes of Health declined to take it, citi=
ng=20
concerns about the loss of privacy and the potential for discrimination in=20
health insurance.</P>
<P align=3Dleft>He also realizes that his daughter has become part of the=20
statistics of under-reported sexually transmitted diseases that the HHS=20
concluded contribute to fertility problems, fetal blindness, ectopic=20
pregnancies, and other reproductive disorders.</P>
<P align=3Dleft>Even he now feels that, if he had it to do over again, he wo=
uld be=20
among the more than 2 million people each year, according to HHS estimates,=20=
who=20
do not seek treatment for a mental illness because of privacy concerns.</P>
<P align=3Dleft>To his distress, he also realizes that all of the department=
=E2=80=99s=20
findings were published in the </FONT><I><FONT face=3DTimes-Italic size=3D2>=
Federal=20
Register </I></FONT><FONT face=3DTimes-Roman size=3D2>prior to the adoption=20=
of the=20
amended Health Information Privacy Rule and enactment of the legislation=20
creating a national electronic health care information network.</P>
<P align=3Dleft>Why had he not paid attention? Why had he not noted the=20
department=E2=80=99s findings that throughout the nation=E2=80=99s history t=
he personal privacy=20
rights of citizens have been at the forefront of our form of constitutional=20
democracy?</P>
<P align=3Dleft>Why had he not relied on traditional standards of medical et=
hics=20
and the oath he had taken upon becoming a physician? Why had he not demanded=
=20
that protecting the individual=E2=80=99s right to medical privacy be made a=20=
principal=20
goal of the health care legislation?</P>
<P align=3Dleft>Could he have gotten swept up in the rush to adopt an electr=
onic=20
national health information system on the unproven promise that it would red=
uce=20
health care costs?</P></FONT><B><FONT face=3DUnivers-CondensedBold>
<P align=3Dleft>S</FONT><FONT face=3DUnivers-CondensedBold size=3D1>CARING=20
</FONT><FONT face=3DUnivers-CondensedBold>P</FONT><FONT face=3DUnivers-Conde=
nsedBold=20
size=3D1>ATIENTS</P></B></FONT><FONT face=3DTimes-Roman size=3D2>
<P align=3Dleft>Devastated by his personal loss and disappointed in the lost=
=20
opportunity to serve his country, Sen. Farnsworth returns to private life an=
d=20
resumes his practice as Dr. Farnsworth.</P>
<P align=3Dleft>One day, he receives a telephone call from the wife of one o=
f his=20
patients, Rodney Rogers. She says that her husband has died of a massive=20
myocardial infarction while traveling on a weekend trip several hundred mile=
s=20
from home.</P>
<P align=3Dleft>When Farnsworth hears that Mr. Rogers had been experiencing=20=
chest=20
pains for several weeks before he died, he asks Mrs. Rogers why her husband=20=
had=20
not gone to an emergency room immediately, since nearly every health facilit=
y=20
and practitioner (and insurers and all of their business associates) in the=20
United States has access to his medical record.</P>
<P align=3Dleft>His wife replies that this was precisely the problem. His em=
ployer=20
was downsizing, and he believed he would be laid off if it became known that=
he=20
suffered from heart disease. (Employers have access to medical records under=
the=20
current system as long as it is part of monitoring an employee benefit=20
plan.)</P>
<P align=3Dleft>As Farnsworth hangs up, he recalls that there had been growi=
ng=20
public concern for years over the loss of personal privacy.</P>
<P align=3Dleft>One of the principal reasons for that concern was the increa=
sing=20
use of interconnected electronic information systems. He knows that concern=20=
is=20
well-founded because cyber incidents and attacks have been increasing at an=20
alarming rate.</P>
<P align=3Dleft>The federal government has never been able to assure the pub=
lic=20
that all legislated privacy rights are being protected, and the federal=20
government has concluded that there is no such thing as a totally secure=20
system.</P>
<P align=3Dleft>He realizes that the HHS was correct when it determined that=
"the=20
entire health delivery system is built upon the willingness of individuals t=
o=20
share the most intimate details of their lives with their health providers."=
</P>
<P align=3Dleft>For the first time, he appreciates that health information p=
rivacy=20
is essential for both a health care system and a government that are respons=
ive=20
to the needs and expectations of the nation=E2=80=99s citizens.</P>
<P align=3Dleft>With his patients increasingly refusing to confide in him,=20
Farnsworth concludes that he can no longer practice effective medicine.</P>
<P align=3Dleft>So he retires to his farm, where he spends his remaining day=
s=20
berating himself for not insisting in 2005 that the electronic national heal=
th=20
information network be built foremost on the traditional ethical standard th=
at=20
personal health information should not be used or disclosed without the=20
patient=E2=80=99s consent.</P>
<P align=3Dleft>Sen. Farnsworth missed his opportunity. It remains to be see=
n=20
whether the current members of Congress will miss theirs.</P></FONT><I><FONT=
=20
face=3DTimes-Italic size=3D2>
<P align=3Dleft>James C. Pyles, a partner in the D.C. firm of Powers, Pyles,=
=20
Sutter & Verville, specializes in health law and health system reform. H=
e=20
currently represents plaintiffs in a class action in the U.S. Court of Appea=
ls=20
for the 3rd Circuit seeking to establish a constitutional right of privacy i=
n=20
one=E2=80=99s personal medical data.</P>
<P align=3Dleft>Pyles can be reached at <A=20
href=3D"mailto:jim.pyles@ppsv.com">jim.pyles@ppsv.com</A>.</I></FONT></P>
<P align=3Dleft>=C2=A9 2005 ALM Properties Inc. All rights reserved. This ar=
ticle is=20
reprinted with permission from Legal Times (1-800-933-4317 =E2=80=A2=20
subscriptions@legaltimes.com =E2=80=A2 www.legaltimes.com).</P></FONT></BODY=
></HTML>
-------------------------------1112163022--