思考与写作stallman.org
我的诊所让我撒谎
My Doctor's Office Asked Me To Lie
2012 — 2013，它一次次回到首页
黑点是上首页（≥ 50 分）的那次投稿，空心点是没冲上去的投稿，点越大分数越高。
导读
Richard Stallman 记述自己在医生办公室被要求签署一份 HIPAA 隐私政策回执，但诊所无法提供该政策（或他并未收到），因此签字等于承认一件不真实的事。他拒绝撒谎，并由此讨论病人面对这类医疗表格时的处境。
为什么经久不衰：它把一张日常医疗表格里的“小谎”提升为关于知情同意、合规官僚与个人诚实的经典案例，今天仍值得读。
HN 评论精选
短表格反而让病人认真追问，医生因被要求履行告知义务而不悦。
我最近在牙医那里有类似经历：他们让我签一份责任豁免，要求我声明已被告知拔牙风险，包括一长串可能的不良结果。我问牙医，她说不用担心，大多数在这里不可能发生；于是我请她划掉不可能发生的项，并解释其他并发症的概率——这是她自己的文件要求她做的。她厌烦地照做后给我拔牙，一言不发走开，显然怪我浪费她时间，因为其他病人签完就完。我反而觉得问题在于表格太短，所以我觉得自己真能合理读完。
rfugger查看英文原文
I recently had a similar experience at my dentist's office. I was asked to sign a waiver of liability, presumably for insurance purposes. It asked me to state that I had been informed of the risks of the procedure (tooth removal), including a long list of possible bad outcomes. I asked the dentist about this, and she said not to worry, most of those couldn't happen here. So I asked her to please strike the ones that couldn't happen, and explain the likelihood of the other complications, as her own document required her to do. After disgustedly doing this, and spending another 20 minutes fulfilling the other requirements of the document she wanted me to sign, she poked a needle in my mouth, yanked my tooth out, and walked away without saying another word. She clearly blamed me for wasting her time, since other patients obviously sign the form and get on with it. I actually think the problem here was that the form was too short, and so I felt that I could actually reasonably go through it, as opposed to a lengthy legalistic form that I couldn't possibly be held to in court if it turned out to be unfair.
合同并非不可修改，公众却普遍把它当作 take-it-or-leave-it。
我不知道美国怎样，但这里（希腊）大多数人不知道合同可以修改，甚至不知道合同有约束力。有人拿公司报价让我签，我读后说“我不授权你们用我的邮箱给我发东西，所以这条我划掉”，包括递给我协议的人在内，大家都看我像最迂腐的人。很让人不安，因为几乎所有人都把合同当成“要么接受要么走开”；当然买新手机时店员无权改合同，但很多情况下你可以改。
StavrosK查看英文原文
I don't know how it is in the US, but here (Greece), most people aren't aware that you can modify contracts, or even that they're binding. I've had various people come up to me with company offers and asking me to sign things, which, after I've read, I said, for example "I'm not authorizing you to use my email to send me things, so I'll strike this clause out". People (including the person who handed me the agreement) looked at me as if I were the most pedantic person in the world, or as if I were trying to make things fall upwards. It's very disconcerting, because nearly everyone treats contracts as a "take it or leave it" affair. Sure, when you're getting a new phone, the employee doesn't have the power to agree to alter the contract, but in many cases you can do it.
按 HIPAA，该诊所可能违规；签回执只表示收到而非同意。
我不是律师，但在我初创公司负责 HIPAA 合规：假设这是标准私人诊所，该办公室有多处违反 45 CFR §164.520(a)(b)(c)，前提是他首次就诊后 30 天内也没收到隐私声明及未提供的理由。每次违规可罚 5 万美元，最高 150 万美元。他对表格的修改是铁证，那个前台应该被开除；2011 年还犯基本 HIPAA 不合规没有借口。补充：签署隐私实践通知不代表你同意其中条款，你只是签收已收到；而且无论签不签，它都适用于你。
haldujai查看英文原文
IANAL but I'm responsible for HIPAA compliance in my startup: Assuming this is a standard private practice, this office has several violations of 45 CFR §164.520(a)(b)(c), assuming that he was also not provided this privacy statement within 30 days with a reason for why it was not provided on the first visit. This makes them liable for $50,000 in fines per failure to a max of $1.5 mm (this would be a clear cut case of reckless indifference.) The DHHS OCR is always looking for some head to serve on a platter to justify themselves as well. His amendment to the form is damning evidence and that receptionist should be fired, there is no excuse for basic HIPAA noncompliance in 2011 (8 years after the fact). Edit: What some people don't seem to understand is that signing the privacy practices notice (the form in question here) does not mean you agree to the terms and conditions outlined. You only sign that you have received them. Additionally, whether you sign the form or not it applies to you, and whatever that form states HIPAA clearly outlines what powers the covered entity (the doctor in this case) has over your information.
药房诱导病人放弃咨询比隐私表格更糟。
我怀疑政策远没有 3000 页，但这种事确实荒谬。读文件对理解其内容意义不大，更别说理解其在法庭学说中的含义。我也坚持在医生办公室读隐私政策；有一次前台很不耐烦，最后把他们唯一打印本给我，只有一页双面，却又皱又破还有污渍。更无意义且更令人不安的是药房在买处方药时指示顾客签/勾“我不希望咨询”栏；我无视指示去签要求咨询的栏，他们严厉说我签错地方，我说我真的想和药剂师谈谈时，他们大叹一口气。
antiterra查看英文原文
While I doubt the policy was anywhere near 3000 pages, this kind of thing is indeed ridiculous. Reading the document means very little in regards to understanding what it says, much less what it means in regards to court doctrine. I also insist on reading the privacy policy at doctors offices. Once, a receptionist gave me a great deal of grief, then finally handed me their only printed copy. It was just one two-sided page, but it was ragged, creased and stained. Classy. What's less pointless and far more upsetting is the practice of pharmacies instructing customers to sign/check the "I do not wish to have a consultation" area on forms when buying prescription medicine. That has happened to me at a number of pharmacies in NYC. When I ignore their instructions and start signing the area that requests a consultation they sternly tell me I'm signing in the wrong place. Then there's a big sigh when I say I actually want to talk to the pharmacist. Inexcusable and disgusting.
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