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Social workers are bound to maintaining confidentiality of information provided by service users. The client provides information on the assumption that the social worker will maintain his privacy even in legal proceedings. However, sometimes social workers are forced to break the boundaries of confidentiality in accordance with legislation, such as in reporting harm or injury to a minor by his/her guardian, even if the latter is the social worker's client. This study examined the attitude of Israeli courts toward the limits of maintaining confidentiality in social work, using a quantitative-descriptive research of documents - judgments selected for this study. In the social work cases presented, the court outlined the boundaries of confidentiality and its perception of social workers' professional work. The findings revealed that social workers' clients rarely filed personal claims against them. The main legal issue raised in the judgments was the removal of confidentiality; most of the judgments found that the breach of confidentiality claim between social worker and client was unjustified. The study concludes by offering several courses of action to help educate social workers in dealing with the desire to maintain confidentiality in daily practice. [ABSTRACT FROM AUTHOR]

This article presents a qualitative study that examined how Israeli social workers contend with ethical issues regarding confidentiality and disclosure in the aftermath of a terrorist attack. Respondents of this study shared examples from their own experiences of how ethical issues emerged as a result of confidentiality obligations. [ABSTRACT FROM PUBLISHER]

Background: High and increasing drug prices have prompted the establishment of a broad range of cost-containment treatment policies in health systems globally. In 2012, the supplemental insurance program of a large Israeli health maintenance organization (Clalit Health Services) introduced a prior authorization process for second-line use of ranibizumab in patients with retinal disease for whom treatment with bevacizumab proved to be ineffective. A Clalit steering committee established authorization criteria based on cost and periodically updated clinical considerations, while a team of ophthalmic specialists evaluated their colleagues' individual patient subsidization requests, based on the funding criteria. The objectives of this study were to detail this unique authorization process and study its effectiveness in limiting unwarranted spending, while allowing for a smooth transition to a second-line more expensive drug when needed., Methods: A retrospective cohort study including all applications for a first or ongoing treatment with ranibizumab, for one or both eyes, received during March 1, 2012 - December 31, 2015. The key parameters examined were percentages of requests from patients treated by first line treatment bevacizumab, requests approved, reapplications, and results. Requests studied include reapplications and requests for treatment continuation., Results: During the study period, Clalit affiliated ophthalmologists' submitted 16,778 funding applications for intravitreal ranibizumab treatment on behalf of 5642 patients who applied for approximately three applications. An efficient sentinel effect was achieved, resulting in only 31% of patients treated with bevacizumab applying for treatment, while maintaining extremely high accessibility to second line treatment with almost 95% of requests being approved., Conclusions: The data presented shows a low request rate for funding with a high approval rate, proving this peer reviewed report-based authorization process successfully achieved a sentinel effect while controlling cost. We suggest this innovative model be considered in similar decisions processes.

Background: Nurse managers are placed in a unique position within the healthcare system where they greatly impact upon the nursing work environment. Ethical dilemmas and moral distress have been reported for staff nurses but not for nurse middle managers., Objective: To describe ethical dilemmas and moral distress among nurse middle managers arising from situations of ethical conflict., Methods: The Ethical Dilemmas in Nursing-Middle Manager Questionnaire and a personal characteristics questionnaire were administered to a convenience sample of middle managers from four hospitals in Israel., Results: Middle managers report low to moderate levels of frequency and intensity of ethical dilemmas and moral distress. Highest scores were for administrative dilemmas., Conclusion: Middle managers experience lower levels of ethical dilemmas and moral distress than staff nurses, which are irrespective of their personal characteristics. Interventions should be developed, studied, and then incorporated into institutional frameworks in order to improve this situation., (© The Author(s) 2014.)