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The peer review process is indispensable to promotion of quality in medical facilities. A major component of the process is honesty; without open investigation and discussion of adverse events and their causes, meaningful reforms for avoiding the same occurrences again are less likely to be made. To ensure open discourse, nearly every state has enacted laws protecting the confidentiality of peer review proceedings. However, federal law may not always be so deferent to the privacy concerns of the peer review committee. In certain circumstances, what most participants thought would be a closed record under state law might be opened by competing federal law enacted to protect the disabled.
Federal vs. State Law: A Case In Connecticut
Following public outcry over reports that disabled persons were being abused and maltreated in care facilities, Congress enacted the Protection and Advocacy for Mentally Ill Individuals Act of 1986 (PAMII), Pub. L. No. 99-319, 100 Stat. 478 (May 23, 1986) (amended in 1991 and again in 2000, when it was retitled the Protection and Advocacy for Individuals with Mental Illness Act or 'PAMII.' See Pub. L. No. 106-310, 114 Stat. 1101, 1193-94 (Oct. 17, 2000), codified at 42 U.S.C. ” 10801-10851.) PAMII provides federal funds for states that have qualifying protection and advocacy (P & A) systems that monitor the care given to those with disabilities and mental illness in care and treatment centers. PAMII came into apparent conflict with Connecticut law protecting the confidentiality of peer review proceedings in a recent case in Connecticut, Protection & Advocacy for Persons With Disabilities v. Mental Health & Addiction Services, 2006 U.S. App. LEXIS 11379 (2d Cir. 5/6/06).
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