Well, it’s time for another question for a fictional scenario in my book! And everyone here is SO smart… I just KNOW that somebody will know the answer.
Here’s the situation:
The main character’s rich, eccentric uncle (Julius) is told that he has an aggressively growing brain tumor and is terminal. He doesn’t want his nephew (Nate, the MC) told about it. Nate lives about a thousand miles away and has no other living relatives. He’s also a minor.
In this case, does Nate have any right to know that outweighs patient privacy? I’m FAIRLY conversant with HIPPA, but I really don’t know what the answer would be here.
No, Nate doesn’t have a right to know if his uncle does not want him too. No hypothetical family members would either including a spouse, children or parents if Julius had them. HIPAA rules are very clear on that and that is exactly the type of privacy it is meant to protect. No medical professionals would be allowed to give Nate any information without his uncle’s express consent.
Poor kid. Well, as it turns out, Julius makes a deal with Satan and doesn’t really die anyway; he just hovers in an undead kind of status. So there’s that.
Just out of curiosity, why would you think that the kid might find out. I can’t think of an IRL situation where that might happen.
You have to sign something to even let them release that information to your spouse. If you want Nate to find out, you can have Julius sign a form when he first registers at that office saying that they can discus Julius’ medical information with Nate. You have, no doubt, signed that same paper at every doctor’s office you’ve ever been at.
Something like this (Sorry, I can’t link directly to it).
If you can write in a way for Julius to write in Nate’s name on this then you can possibly write in a way for Nate to find out, legally.
Maybe he misses some appointments and they call Nate out of concern? Maybe Nate does some snooping (calls neighbors) somehow and finds out that he goes to that doctor and they tell him what’s going on? I dunno, but if his name is on that form, they can talk to him without breaking any HIIPA laws, I think.
Is Nate his closest living relative?
If so, when Julius becomes incapacitated from his disease, and if Nate is present in the hospital, he will be given updates on his prognosis and treatment.
If he is not present, or he is not the closest living relative, then no, he will not know unless another family men=mber tells him.
Well, here’s one thing that I did think of. The uncle has a glioblastoma, which actually does have a strong genetic basis. Here’s something about that. In the fictional scenario, scientists found out within the last year that these kinds of tumors are 100% genetic. Genetic diseases DO have to be revealed to close relatives.
SO… what kind of scenario could happen from that? All ideas welcome.
To clarify, HIPAA rules apply only to medical doctors and related professionals. I believe this law covers a wide umbrella, so if Dr. Smith (Uncle Julius’s doctor) is discussing the case which is overheard by Dr. Jones (the hospital shrink) then Dr. Jones would be forbidden from telling anyone even if he doesn’t treat Uncle Julius.
Non-medical personnel, such as family members, are not affected by HIPAA. Nate’s older brother may know about Uncle Julius’ cancer and there is no law preventing him from telling anyone – in fact, Nate’s brother may decide to tell Nate anyway, against Uncle Julius’ wishes, if he feels there is a moral imperative to tell Nate the truth.
Since this appears to be a fantasy novel, Nate could learn the truth from a tarot card reading, or hearing angelic voices, or maybe even by bribing Satan himself. (I’m pretty sure Satan isn’t bound by HIPAA.)
The thing is, though, that I really want to avoid the entire magical realism genre, including any aspect that drifts into it. Picture something much more like a Stephen King-type narrative voice, where there’s a HUGE divide between the real and the unreal, and characters spend a lot of time and energy trying to deny the supernatural things they’re witnessing.
So… overall, it would be most useful, I think, to try to figure out if the genetic link thing would work. I’m looking for truthiness.
In THIS example, you see, it’s a type of tumor that can kill within weeks, and can occur at any age. (By the time the truth is finally revealed, Nate is about 21.) So I guess another question is-- is that scenario believable to the point where doctors reading this wouldn’t just laugh?
Glancing at that article (without clicking on all the footnotes) makes it seem like that doesn’t override HIIPA it just sorta makes it seem like if someone does decide to go around the HIIPA laws with the blessing of the ethics committee at the group they work for, they’ll probably be in the clear it the patient decides to sue them. They’ll probably also need the person that they gave the information out to to be on their side on not on the plantiff’s side.
Not telling them is HIIPA, that’s law.
Telling them is “ICN Code of Ethics”. I assume that’s not law and that HIIPA overrides that.
Has Julius ever been close with Nate? Would there ever have been any reason for him to put his name on that Patient Consent form I linked to earlier? If he signed that, maybe even with his GP earlier that year and his GP had all of his medical records (would he have a copy of this) you might be able to make this work?
Is there a good reason for the nurse that’s going to inform Nate to know that Nate exists and know how to get a hold of him? I mean, I don’t talk to my doctors about my relatives that live thousands of miles away.
Okay, so here’s the exact situation, which it might help to know.
Julius (creepy old uncle) was diagnosed with this tumor pretty recently, so he could die at any time. He and Nate are the last of the family. Nate’s father also was diagnosed with the tumor… but he and all the other relatives died in a mysterious bus accident when Nate was seven years old.There is brand new medical information showing that this tumor is actually a lot more likely to strike younger people without any warning. So Nate could pretty much drop dead any day now.
I think…
(goes back to research what happened… um, I mean, what the FICTIONAL SCENARIO is…
Julius did sign a patient consent form at one point, because he realized that it would have looked too strange to others if he didn’t. He’s been working for several years on a project to cheat death, using mysterious records in the family library hinting at a deal with an unearthly entity that fell through. What he didn’t expect was for the familial death sentence to descend at that time, because he’d already figured out that it had always been a lot more likely to strike younger people.
So the upshot of all this is that Dr. Burns (the neurologist) called Nate and asked him to come back home. (The nurse was literally the one who called, but you know what I mean.)
Well, as it turns out, Julius makes a deal with Satan and doesn’t really die anyway; he just hovers in an undead kind of status. So there’s that.
