Contact: Kathryn Serkes
(202) 333 3855

March 22, 2005

The Association of American Physicians and Surgeons has joined the "Patriots to Restore Checks and Balances" coalition, citing specific concerns over the threat to medical privacy as a result of provisions of the Patriot Act, as announced at a news conference held today in Washington D.C.

"Patients who fear disclosure of all their sensitive information to government agencies have no choice but to withhold the information from their physicians," said Kathryn Serkes, AAPS Director of Policy and Public Affairs.

A mailed survey of 344 physicians conducted by AAPS demonstrates the chilling effect of fear of government disclosure on patient communication. Physicians already believe that third-parties ask for information that they

believe to violate confidentiality, with 51% reporting such requests from government agencies.

Nearly 87% reported that a patient had asked that information be kept out of the record, and nearly 78% of physicians said that they had indeed withheld information from a patient's record due to privacy concerns. While only 19% admit to lying to protect a patient's privacy, 74% state that they have withheld information for that reason.

"Patients are withholding information, and doctors are lying to protect a patient's privacy," said Serkes. "The obvious conclusion is that virtually unrestricted disclosure of medical information to government agencies as allowed by the Patriot Act will only exacerbate the situation to the point of distorted, incomplete and potentially dangerous medical records becoming the norm. Physicians' ethics will be further challenged, the choice between government compliance and lying for a patient." Here is the entire text of the AAPS statement at the news conference:

I am Michael Ostrolenk, Director of Government Affairs for The Association of American Physicians and Surgeons, a national, non-partisan professional association of physicians. AAPS represents thousands of doctors and hundreds of thousands of patients. We are dedicated to the highest ethical standards of the Oath of Hippocrates and to preserving the sanctity of the patient-physician relationship.

First we would like to thank Congressman Barr for having the foresight to see the need to create such an important trans-partisan coalition as Patriots to Restore Checks and Balances. We are honored to be part of this group.

AAPS have been fighting since its inception in 1943 against repeated government attempts to grow its power and limit our God-given liberties as articulated in the first ten amendments to the Constitution. We take very seriously the Bill of Rights especially the Tenth Amendment. We therefore work from the premise that if government has any role to play in the practice of medicine, it would not be the Federal government but at the State level. Unfortunately, history has shown us that the Federal government has taken a greater and greater interest in and regulation and control of the practice of medicine. One area of great concern for us is in medical privacy. Our ethical code states:

"The essence of the physician-patient relationship is trust. It allows patients to reveal the most intimate details of their lives to their physicians who hold the information in confidence.

When a patient fears a disclosure, he or she may withhold the disclosure of certain symptoms or facts from the physician. Furthermore, physicians who expect disclosure may record information selectively. In other words, the process of healing is harmed because either the patient or physician may withhold essential information."

How does this all relate to the USA Patriot Act? Well, many of its provisions just continued a trend of federal government assaults against medical privacy. In 1996, we had HIPPA and its misnamed privacy rule which gave broad exemptions for accessing private healthcare information for law enforcement, national security and other government purposes.

It permits disclosure of medical information without limitations for the conduct of lawful intelligence, counter-intelligence and other national security activities authorized by the National Security Act. This permits the government to obtain databases full of medical records for data mining purposes with no subpoena or court order.

The regulations under HIPAA also permit disclosure to Federal, state and local law enforcement officials in response to a court order, judicial subpoena and with an administrative request. This would include a court order under section 215 of the USA Patriot Act which allows the FBI to obtain any business records including medical records sought for terrorism or intelligence investigations. Section 215 allows the FBI to obtain a court order to access an entire database of privately held business records without having to specify the target of the investigation.

We also have the National Security Letter authority. The USA Patriot Act broadened the FBI's authority to use National Security Letters in such a way that they do not even have to identify a particular suspect whose records are sought. This is without judicial review. We can see from all of this that the privacy of Americans medical records is in jeopardy and so is the practice of medicine.

The Federal government has not shown the ability to limit its terrorism investigations to legitimate issue of national security. It is also clear that they have a disregard for our founding principles and our constitutional protections. I refer to Patrick M. Hughes from the Department of Homeland Security. He said in 2003 in a forum at Harvard that

"We have to abridge individual's rights, change the societal conditions, and act in ways that heretofore were not in accordance with our values and traditions, like giving a police officer or security official the right to search you without judicial finding of probable cause."

This means that law abiding citizens who have no connection to those who perform and fund terrorist acts can expect to have their liberties further limited. They can also get caught up in so-called national security investigations without their fourth amendment rights protected and therefore have their very private and personal information that is stored in their medical records accessed by Federal agents.

We see medical privacy as a constitutional right and an ethical necessity for the practice of medicine. Our rights must be strictly guarded by the government which itself was instituted by our founding fathers to secure those rights.

It would seem that the government has forgotten its purpose and the limits placed on it by our constitution. This is why we stand here today to join with other groups to encourage the President to change his mind, support our cherished and God-given liberties and make sure the proper checks and balances are in place. Thank you.