The past dozen years have witnessed an astounding rise in costs relating to the prevention and management of medical malpractice claims. Not surprisingly, a crisis of trust has also been building over the same period. Public interest in alternatives to traditional health care has increased as has the plethora of defensive medical procedures in hospitals. In addition, the past decade has seen the rise of such hospital professions as risk management, patient representation, quality assurance, and utilization review. The current high interest in “patient services” and “patient relations” is just that-current: a reflection of low priority until gathering crises made such interests relevant.

The cost crisis has led to both reactive and preventive behaviors on the part of hospital personnel. Reactive behaviors are those designed to respond to errors and claims after they occur. Examples are incident investigation, adjustment decisions, and insurance reserve manipulation. Preventive behaviors are designed to head off incidents before they occur, by identifying and reducing sources of clinical error, legal liability, and patient aggravation.

Under a variety of circumstances, courts of law have attempted to compel pharmacists to publicly disclose confidential information contained within the pharmacists’ prescription drug records. The disclosure of patient medication records maintained by a pharmacist has been sought in a civil action against a drug manufacturer, a child custody proceeding, a civil action against a physician, and criminal prosecutions of a pharmacist and a physician A request for production of clearly confidential information places the pharmacist in a dilemma. The Code of Ethics of the American Pharmaceutical Association allows for the unauthorized release of a pharmacist's professional records only where it is required in the best interests of the patient or demanded by the law. Therefore, pharmacists have sought judicial clarification of the circumstances under which the law demands the release of information contained within confidential patient medication records.