| Course | HI570 Legal and Ethical Issues in Health Information |
|---|---|
| Unit | Unit 10 |
| Paper type | Legal and ethical position paper |
| Length | About 1,120 words, 7 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | MS in Health Informatics |
| Updated | October 2026 |
Free sample paper for HI570 Unit 10
Keep the Note, Review the List: A Unit 10 Legal and Ethical Position Paper on a Request to Delete an Alcohol Use Disorder Diagnosis
[Student Name]
Purdue University Global
HI570: Legal and Ethical Issues in Health Information
Unit 10 Legal and Ethical Position Paper
[Instructor Name]
[Date]
Larchmere Health, the patient, the clinicians and every date are composite; the regulations and sources cited are real.
The Case
On February 3, a 44-year-old man came to Larchmere Health's emergency department after a fall on ice. He had a scalp laceration and smelled of alcohol. The emergency physician repaired the laceration, documented that the patient reported drinking six to eight beers most evenings and two prior falls, and recorded the diagnosis "alcohol use disorder, moderate" with a brief counseling note. The diagnosis was added to his problem list automatically when the note was signed.
On March 10, the patient submitted a written request to amend his record by deleting the diagnosis from both the emergency note and the problem list. He wrote that he had been "drinking more than usual that winter," that he has since cut back, and that an insurer reviewing his application for a life insurance policy had asked about the diagnosis. The emergency physician reviewed the request and responded that the documentation accurately reflected the history the patient gave and her clinical judgment at the time.
Under the Privacy Rule, Larchmere has 60 days from receiving the request to act, with a single 30-day extension available if the patient is told the reason in writing (45 C.F.R. § 164.526, 2024). The deadline is May 9.
Authority
Which record. Both the emergency note and the problem list belong to Larchmere's designated record set, since clinicians rely on each when deciding his care, and Larchmere wrote both. The patient's right to request amendment applies to each.
Which grounds. Four grounds allow a denial: someone else created the information, it sits outside the designated record set, the patient could not inspect it, or it is already accurate and complete (45 C.F.R. § 164.526, 2024). Only the last ground is relevant here.
What a denial requires. A denial must be in writing, in plain language, and must state the basis for the denial, the patient's right to submit a written statement of disagreement, his right to ask that his request and the denial accompany future disclosures if he does not submit a statement, and how to file a complaint with Larchmere or with the federal health department. If he submits a statement, Larchmere may prepare a rebuttal, must give him a copy, and must link the request, denial, statement and any rebuttal to the record and include them, or a summary, with future disclosures of the disputed information.
Which rule does not apply. The stricter federal rules for substance use disorder records do not reach this note. They cover programs that receive federal support and advertise themselves as places to get diagnosis, treatment or referral for those disorders (42 C.F.R. § 2.11, 2024). A general emergency department that diagnoses a substance use disorder while treating an injury is not such a program, so the ordinary Privacy Rule applies.
The law gives the patient a voice in his record, not a veto over a clinician's judgment that was accurate when it was made.
Principle
Two values pull against each other. The first is the integrity of the record. An emergency note records what a clinician learned and concluded at a specific moment. If notes could be rewritten whenever a later purpose made their contents inconvenient, every record would become negotiable, and the next clinician could not trust what earlier ones wrote. AHIMA's ethical standards commit the profession to accurate, intact records and to declining any change made for an outside purpose (American Health Information Management Association [AHIMA], 2019).
The second is foreseeable harm. A diagnosis can follow a person into insurance underwriting and employment decisions long after the condition has changed. Nonmaleficence asks the organization to avoid causing harm it can foresee where it can do so without a greater wrong (Beauchamp & Childress, 2019).
These values apply differently to the two parts of the record. The emergency note is a historical document; its integrity value is at its highest, and it described the visit accurately. The problem list is a living summary meant to reflect the patient's current conditions. An entry added automatically from one emergency visit, never reassessed by a clinician who knows him, can cause harm the note does not, because it presents a moment's judgment as a standing fact.
Position
1. Deny the amendment of the emergency note on the ground that it is accurate and complete. Send a written denial meeting every requirement above, inviting a statement of disagreement.
2. Accept and attach his statement of disagreement to the note if he submits one, so his account of the period travels with the record.
3. Refer the problem list entry to his primary care physician for review at his next visit, which falls within the 60-day window, with a request to reassess the diagnosis and update the list to reflect his current condition. If his physician confirms the diagnosis, the entry stays; if the physician concludes it no longer applies, it can be marked resolved, which is a clinical update rather than an amendment of the historical note.
4. Tell the patient in the denial letter that the problem list is being reviewed separately and by whom.
Why This Is Not a Compromise for Its Own Sake
The split is not a way of giving each side something. It follows from what each part of the record is for. A resolved problem list entry does not erase the emergency note; anyone reviewing the visit will still see what was documented and why. And keeping the note does not require the problem list to carry an unreviewed label forever. The position joins record integrity and harm avoidance at the point where each properly applies.
Objections
One objection is that marking the entry resolved is amendment by another name. It is not, because the change rests on a new clinical assessment, not on the patient's preference, and the original entry and its history remain visible. A second objection is that the life insurer will see the note regardless. That is likely true if he authorizes release of the full record, and the paper does not pretend otherwise; his statement of disagreement is his best response there.
Limits
State insurance and privacy laws may give him additional rights or restrict what insurers may ask, and counsel should review the denial letter. The paper does not address whether the original counseling met emergency medicine standards.
References
American Health Information Management Association. (2019). AHIMA code of ethics. AHIMA.
Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
42 C.F.R. § 2.11 (2024). https://www.ecfr.gov/current/title-42/chapter-I/subchapter-A/part-2/subpart-A/section-2.11
45 C.F.R. § 164.526 (2024). https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.526
Reading the HI 570 Unit 10 instructions
The final unit typically asks for a position paper that resolves a health information case on both legal and ethical grounds. Expect to state the case with dates, establish the legal authority precisely, analyze competing principles, take and defend a position, answer objections and note limits. Around nine pages in five parts is a common shape. Get the authority exact: which record, which right, which grounds, which deadline and what any required notice must contain. Argue principle separately before joining the two. Where different parts of a record serve different purposes, consider whether they deserve different answers. Answer the strongest objections directly. Keep the position practical, with steps and who carries them out.
How this HI570 Unit 10 example is built
The case section gives the emergency visit, the diagnosis, the amendment request, the physician's response and the deadline. Authority covers which records are in the designated record set, the denial grounds, the contents of a denial letter and why Part 2 does not apply, and the highlighted sentence summarizes the patient's voice without a veto. The principle section weighs record integrity, supported by the AHIMA code, against foreseeable harm, and distinguishes the historical note from the living problem list. A four-step position follows. A section explains why the split is principled rather than a compromise. Two objections are answered, and limits note state law and counsel review.
Where the points sit in the HI570 Unit 10 rubric
Final position papers are commonly scored on legal accuracy, ethical reasoning, coherence of the position, response to objections and writing. Legal accuracy and coherence usually carry the most points, rewarded when authority is exact and the position follows from both law and principle. Ethical reasoning earns credit when competing values are weighed on the facts, not listed. Responses to objections show depth and are increasingly expected at the graduate level. Practical steps with owners add credit. Organization, tone and correct citations complete the rubric. Papers that assert a position without exact authority, or split the difference without explaining why each part deserves its answer, tend to lose points.
Common HI570 Unit 10 mistakes, and how to avoid them
A frequent reason final papers are returned is imprecise authority, such as a wrong deadline or a missing element of the denial letter. Another is treating any record containing a substance use diagnosis as covered by Part 2. Some students argue principle only in general terms. Positions that give each side something without a reason read as compromises rather than arguments. Objections are often skipped, and deadlines are sometimes counted from the wrong date, which a grader will check. If your final case is different, perhaps a request to remove a minor's record entry or to correct a misattributed note, gather the facts and your earlier unit work, and we can draft a position paper that holds law and ethics together.
Get an HI570 Unit 10 example written to your instructions
Share the contested decision your Unit 10 prompt assigns, or the case you carried through the term, with the rubric and whatever length limit applies. Within 24-48h a free first position paper comes back defending one decision from authority and from principle, with the strongest objections answered rather than listed. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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HI570 Unit 10 questions, answered
Can a patient force a hospital to change a diagnosis in the record?
Not if the information is accurate and complete. The Privacy Rule gives patients a right to request amendment and allows denial on that ground, among others. A denied patient may submit a statement of disagreement, which must then accompany future disclosures of the disputed information, and the organization may prepare a rebuttal. None of this is legal advice; the case was invented for the course.
Why does the paper discuss 42 CFR Part 2 if it does not apply?
Because deciding which rules govern is part of the analysis, and substance use diagnoses invite the mistake. Part 2 reaches only programs that receive federal assistance and present themselves as offering substance use disorder diagnosis or treatment, along with certain recipients of their records. A diagnosis recorded in a general emergency department is ordinarily outside it, and saying so briefly shows the classification was made on purpose.
How long should the position paper be?
Follow the prompt; closing papers in graduate courses often run eight to twelve pages. Length should come from the number of objections answered, not from background. A paper that spends three pages on the history of privacy law before stating its position will usually read as padded, whatever its total length.
What must a denial of an amendment request include?
A plain-language reason, the right to submit a statement of disagreement, the option to have the request and denial attached to future disclosures, and how to complain to the hospital and to HHS.
Where can I find a free HI570 Unit 10 sample paper?
The whole Unit 10 position paper is on this page, defending a split decision on a request to delete an alcohol use disorder diagnosis.