So what I got from this is that police feel like they can search your home without consent over a facebook profile photo.
Nice.
He should have requested help from the ACLU, sued the person who made the call that he needed to be forcibly taken in, and sued the police department for illegal search, while making the case VERY public.
I was wrongfully committed once by a vengeful relative (not even blood) who deceitfully pretended to be my guardian, making up shit about my state of mind.
The government is still hounding my mother about the medical bills, which she refuses to pay because she did not even find out what was going on until I was committed and could not be released. I was kidnapped from her house and was led to believe we were going somewhere else. Next thing I know, a police officer is at the car window telling me we can do this the easy way, or the hard way.
I take this kind of intrusion on personal liberty to be especially heinous.
> He should have requested help from the ACLU, sued the person who made the call that he needed to be forcibly taken in, and sued the police department for illegal search, while making the case VERY public.
While I agree with you in principle, it should also be noted that some people may not want their mental health treatment to become a matter of public record. It may affect their future in unpredictable ways (employment, relationships, legal disputes, etc). It could be used against them down the road.
I despise how someone who makes a false accusation always has the upper hand over the accused. People need to develop a healthy distrust of unconfirmed sources, especially in the age of Photoshop, face- and voice-swapping neural nets, and extreme trolling.
Haha you're telling me, I'm also a victim of a physical assault where the assailant told all of my friends immediately after the incident that it was I who assaulted her. Lost a lot of friends over that one and got called a future rapist by people who had never even met me.
It's forever in the back of my head that some of my remaining friends still secretly believe I did it. All because I had the courtesy to not immediately tell people about what she had done. Learned my lesson there. The first to report has the upper hand :)
I wish there was a way to give a psychologist all my online tracks (down to Slashdot posts when I was 12), context of what I was thinking around the posts, and along with the usual story of my life. Then diff it against "normal" and provide advice--"because of X you seem to react Y so maybe try Z".
Dear god, I hope there isn't. While my online persona is pretty much the same as my real-life persona, I know quite a few people who have more than one online identity. I would hate to have someone characterized with a mental illness because their psychologist came across their old tumblr or livejournal.
The disagreement between the two of you is kind of paralleling an emerging debate over trends in mental health assessment research.
Right now, there are large grants (from the federal government) being dispersed to develop systems to basically scrape patients' social media info and smartphone data (including things like GPS, accelerometer data, etc.) to predict outcomes. There's other related research going on too.
Traditionally, assessment methods work more like an instrument: you introduce a stimulus and record a response. I don't think that's going to change, because of various advantages of that sort of data, but the utility of other types of data is being actively discussed. You have privacy issues like are being discussed here, but there are also practical issues like: what if your severely mentally ill patient doesn't have a Facebook account they use regularly? What if they don't even own a phone, or use it, which common?
Looking for patients on the web isn't uncommon. It's not really so much your depressed office manager, it's your patient who is being court-ordered for some service because they pulled a gun on their girlfriend and used the butt of it to knock their 2-year-old over. Imagine that they come in, and you're supposed to be monitoring their danger to self or others, and aren't willing to say much to you, and won't consent to have you contact a third party, or don't even have a third party to contact. If a situation arose where you could find something on Google, would you refrain from searching it? What about an online public government-run database? What about reddit? What about Facebook? Where do you draw the line? Should the courts be ordering that psychologists and psychiatrists be able to scrape your phone? Install an invasive monitoring app? What if you haven't been convicted yet? What if you aren't charged with anything, but have been deemed incompetent to make your own medical decisions?
If a situation arose where you could find something on Google, would you refrain from searching it? What about an online public government-run database? What about reddit? What about Facebook? Where do you draw the line?
The courts have already answered this question for a different audience: the police. There is already a rich legal body of knowledge and practice that governs where and when searches are appropriate. That should be the minimum baseline for mental health professionals. If a police officer, a person trained and vetted by the legal system to detect threats and use (up to lethal) force to end them cannot access this data, there is no way that some damn civilian should have access. If you want access, get a court order, just like a police officer, just like a state attorney. No court order? Fuck right off.
In your case, I can easily see a judge saying that the person in question is legally mandated to turn over social media accounts for some period of time as a condition of their sentence or parole.
Never ever publicly tell stuff like that you're suicidal. It's a recipe for disaster. People think they have to send police after you, lock you up and put you under watch - mostly causing more harm and problems than good. They actually think that it is morally okay to violate your freedoms in this situation. Get help - the best way would be to talk to someone face to face. Don't post morbid stuff on the net, you worry everybody crazy.
Are you saying it's not morally ok to stop suicidal people? You really wouldn't even if it was your friend or loved one? Would you want them reading comments like this, telling them to keep it secret?
Yes, that is what I am saying. My respect for self-ownership and individual choice runs so deep that if someone truly wants to die (not as in voicing suicidal thoughts as a cry for help, but actually wanting to die), I'd respect that. If someone has the right to live, they should have the right to die.
As for telling them to keep it a secret (at least to the public) - that is not because I would mind. It's just an advice to protect themselves because society tends to react to this stuff in extremely retarded ways.
Most people who attempt suicide and survive say they regret it. Usually almost immediately. Suicidal moods are often temporary and they would be fine if they waited it out. I might agree in principle that people have a right to end their lives. But in practice it seems like suicidal people are not making a perfectly informed decision and are better off being saved from suicide. And suicide doesn't just affect that person, it affects everyone around them too you know.
And therefore I honestly think comments like yours are dangerous. Telling suicidal people to stay quiet and not get help they need, or even encouraging them to do it.
This is something that personally affects me a great deal. I have a close friend who often has thoughts of suicide. I dread that the day will come I will find out they are dead, and I will be devastated. I'd do anything to prevent that. Their moods are always temporary and they go back and forth from being depressed to on top of the world in just a few days.
>Most people who attempt suicide and survive say they regret it.
And later on they may regret failing their attempts.
>But in practice it seems like suicidal people are not making a perfectly informed decision
Many people don't make perfectly informed decisions about a variety of things, yet we allow them to exercise their freedom to do so.
>And suicide doesn't just affect that person, it affects everyone around them too you know.
That's a stupidly selfish and ignorant argument of everyone around the person. "You gotta keep on living because otherwise I feel sad." Not even considering that the mourning of a death of a friend is nothing compared to the suffering of a full-blown suicidal depression. If someone had terminal cancer and was suffering horrible pain every day, you wouldn't tell them to go on because them dying "affects everyone around them too you know".
>Telling suicidal people to stay quiet and not get help they need, or even encouraging them to do it.
I did neither of those. I clearly stated "Get help". I clearly stated to seek out dialogue, but not publicly over the internet. I never encouraged anyone to kill themselves, I just want to protect the liberty of anyone to do it.
I think it's really hard, if not impossible, to make that determination, and that's the moral hazard. There are also people who believe that any desire to commit suicide is a mental health issue that can and should be fixed.
I think it's reasonable to always err on the side of caution, since obviously we can't (yet) reverse death, so there's no going back in the case where the causes of the suicidal feelings can actually be fixed.
But I also believe in self-determination: if you really are determined to end your life -- for any reason -- you should be allowed to do so.
So I guess I'm personally somewhere in the middle: try to stop suicide attempts, but if, after getting help, the person still wants to end their life, maybe you should just respect their wishes and let them go, as hard as doing so may be.
Telling that John Doe is your patient is still different from just asking "you know John Doe?". The latter only discloses the fact that you know the name, and the rest isn't a certainty.
For example, if a doctor searched for their patient's name once and haven't ever searched for any other patient, but have searched for, e.g., a family member or a friend - it probably doesn't disclose enough information to be a privacy violation. If doctor looks up every patient they have, it's obvious they're leaking that data and if the laws forbid this level of disclosure - they should be held accountable. The article suggests something in between - so I don't think it's obvious whenever it's legal or not. It's likely to be not (in a real-world scenario), but still...
(And if doctor generates ton of random but real names and mixes in some patient names indistinguishably - it's probably okay, haha. Of course, that's not what happens, either.)
By typing it into their search form and sending it to their server, and especially on "social networks" by the further (non-)interaction with the person?
HIPAA rules specifically permit incidental disclosures that accompany a permitted purpose such as relating to safety, patient communication, or health treatment, including payment.
If your doctor has a reasonable reason to Google a patient beyond mere curiosity, HIPPA would allow the search to take place because the revelation of a name is considered a 'minor' disclosure, and was incidental and as minimal as possible.
If HIPPA didn't have such exclusions, merely calling a patient by name in a crowded waiting room would be a violation.
> HIPAA rules specifically permit incidental disclosures that accompany a permitted purpose such as relating to safety, patient communication, or health treatment, including payment.
I think those really are very different cases. For example, telecommunication is protected by other laws. So, yes, a doctor may call you and even speak into their telephone about your medical information, thus effectively transmitting that information to their telco, but then, telecommunication providers are not allowed to listen to calls or use the contents for marketing purposes, or whatever.
> If your doctor has a reasonable reason to Google a patient beyond mere curiosity, HIPPA would allow the search to take place because the revelation of a name is considered a 'minor' disclosure, and was incidental and as minimal as possible.
First of all, it's not just the name being disclosed, it's the link to the doctor that's being disclosed. And the question is: Well, was it minimal? How do you determine that? And was it incidental? What are the criteria?
Imagine a doctor called everyone in their city, asking them if they knew anything about their patient. Not out of curiosity, but because they are trying to get a better understanding of the medical situation of their patient. They are only disclosing the name, so it's a minor disclosure, right? And also, it was just incidental, right? They didn't call to tell everyone who their patient is, they called in order to collect information they thought could help them!
Now, how exactly is that actually different from asking google? The number of humans involved? What if you hired a detective to collect information on your patient? At least, you then could put confidentiality clauses into the contract, instead of giving the information to a company where your use of the service implies accepting some TOS that allow that company to essentially use the information to make money in any way the like!
> If HIPPA didn't have such exclusions, merely calling a patient by name in a crowded waiting room would be a violation.
Well, that doesn't seem like a particularly convincing argument to me. They are physically present and essentially identifiable to the other people in the room anyway, and essentially due to their own decision to go there. So, yeah, there probably is a need for exclusions that allow this, but that example doesn't really help with figuring out where the limits are or should be.
HIPAA exceptions in recent years have focused on both identifying information and medical condition together.
For example, the NCIS exception allowing mental health staff to disclose to NCIS if an individual should not be permitted to own a firearm due to their mental state. That's a revelation of both the name and their medical information.
Or the finance exception, that allows payment processors to know the names of patients without requiring them to have a business agreement with the medical agency and subject themselves to HIPAA rules. They have no access to medical records and aren't sufficiently entangled with the medical practices so it's been ruled that they are except.
Or the media exception, in which you can disclose that a patient is in 'stable' or otherwise condition in the ER if a member of the media calls for them by name. In this case, the media already knew the name, and the disclosure is deemed for the public good.
Now.... sharing a name with Google to receive completely public information about a patient? That's not something that's specifically prohibited or denied. It could be argued that Google had a 'need to know' just to deliver the search result, and as others have argued, Google cannot connect an arbitrary name search to a patient's medical history.
If it were to come up, the deciding factor would be was the search for the patient's benefit? Name disclosures have historically been deemed to be minimal if there's no other information attached, and HIPAA provides wide latitude to doctors to use a patient's name in the ordinary course of business or to further treatment goals by contacting people or organizations not directly related to the patient.
> Well, that doesn't seem like a particularly convincing argument to me.
Keep in mind all of my examples are simply that... examples. They're not arguments into themselves.
Imagine you were a sort of "librarian of world-wide knowledge" that people would call to ask all kinds of questions they had. Imagine there were this one person who asked you a lot of questions about all kinds of mental health problems, and then also quite a lot of names of people, in particular during working hours. Are you telling me you wouldn't possibly get the idea from that that a significant proportion of those people would be their patients?
Or are you saying that as long as there is no absolute certainty, sharing of medical info is perfectly fine? So, there shouldn't really be a problem with a doctor publishing the medical file of a patient in the local newspaper ... after all, how should the reader be certain that it's not just a fake of someone the doctor doesn't even know?
The question of "history" really is secondary here. What's forbidden is not that people you tell information about your patients write it down, what is forbidden is telling them in the first place.
Be careful what you wish for. Making such information free and public could open you up to all kinds of tracking and discrimination, not to mention higher costs for insurance or credit.
Anonymize it and I'm there, though this certainly would not help in this situation described by this article.
It's been illegal for awhile for health insurance companies to use genetic information. And now they can't even discriminate against any preexisting conditions.
But how would you know if they had? My insurance bill doesn't give me a breakdown of how they decided my premium. And how do you know that they won't be able to in the future? Healthcare regulations are subject to the whims of the current government.
For now: the final ACA replacement bill isn't quite ready for a vote. The final language may end up allowing for discrimination against preexisting conditions. It's not unreasonable to suggest that laws protecting against use of genetic information could get repealed someday either.
My genome is mine. While I'm aware of the negative consequences sharing my genome causes others sharing large portions with me, the benefits outweigh the negative consequences.
Genetic information can reveal that sample being tested belongs to the close relative of a known person. Also the type of the relation can be verifies (sibling, parent etc).
This means that DNA of your close relatives is not anonymous anymore.
Although I agree we all have our own moral code, and you literally don't need anyone's consent to do anything.
The consequences of your actions can be far reaching and perhaps some future version of yourself can come to terms with the fact - it is likely immoral by your future code of ethics, to give out personal data on your family members without their consent.
You can't change giving out data, while your morals can change. That is why being conservative with your data is beneficial. Your future self may change their mind.
As a social media self-exile I have to laugh at the (emphasis mine) "increasing openness of our lives, which we increasingly spend online..." Who's this 'we'?
If someday I'm unfortunate enough to have to see a doctor, and they Google me, they'll find nothing. What happens then? Will they have to do their job using only the information I specifically provide them? Horrors.
Nice.
He should have requested help from the ACLU, sued the person who made the call that he needed to be forcibly taken in, and sued the police department for illegal search, while making the case VERY public.
I was wrongfully committed once by a vengeful relative (not even blood) who deceitfully pretended to be my guardian, making up shit about my state of mind.
The government is still hounding my mother about the medical bills, which she refuses to pay because she did not even find out what was going on until I was committed and could not be released. I was kidnapped from her house and was led to believe we were going somewhere else. Next thing I know, a police officer is at the car window telling me we can do this the easy way, or the hard way.
I take this kind of intrusion on personal liberty to be especially heinous.