A proposal that would allow patients being treated for addiction to consent to disclose their records to the healthcare system affiliated with their provider is spurring a debate about privacy, according to NPR.

The proposal, from the Department of Health and Human Services, would update current privacy guidelines, which last received a meaningful revision in 1987, before electronic medical records were widespread and integrated.

Advocates on both sides agree that protecting privacy of people being treated for substance use is very important. If the information becomes public, a person’s work and family life may be affected. The revelation may have legal consequences, including arrest, prosecution and jail. Some people may avoid seeking help because they fear others will find out.

Proponents of the change say existing privacy rules are too unwieldy for today’s healthcare system. Currently, doctors are not allowed to disclose treatment information unless the patient gives consent to release it to another specific provider. Under the proposal, patients could give their consent to disclose their records to the healthcare system or accountable care organization affiliated with a provider.

Dr. Wanda Filer, President of the American Academy of Family Physicians, says if all of a patient’s providers do not have relevant information about their treatment, it can harm their health. For instance, if a person is taking methadone to treat their addiction to heroin, their doctor may need to adjust their dose of antidepressant or anxiety medication.

Some patient advocates say the privacy rule changes are too sweeping. Jim Pyles, an expert on patient privacy who has represented the American Psychoanalytic Association on this issue, told NPR that under the proposal, anybody throughout the system can get access to patient substance use treatment records. “When the patient is at their most vulnerable time, it gets them to sign … this very general consent form,” he said.