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Fresno State's student-run newspaper

The Collegian

Fresno State's student-run newspaper

The Collegian

The limits of privacy

IT̢۪S UNKNOWN WHETHER THE NORTHERN Illinois University shooter Steven Kazmierczak, who killed six including himself on Valentine̢۪s Day last week, was attempting to copy-cat the Virginia Tech shooting that occurred only 10 months prior. However, the two shooters had one thing in common: their mental state.

CNN reported that Kazmierczak was a likeable above-average student who, up until a couple weeks before the school shooting, didn̢۪t appear suspicious at all. The differing factor in those weeks was that he stopped taking medication for his unreported mental illness.

Similarly, some of those on staff at Virginia Tech who knew gunman Cho Seung-Hui had concerns about potential untreated mental problems.

Why does it seem that no one tried to help these young men? And in the case of Cho Seung-Hui why didn̢۪t school officials work harder to notify his family about their suspicions?

The reason is the Privacy Rule contained in the terms and conditions of the Health Insurance Portability and Accountability Act of 1996, originally passed under the Clinton administration to protect personal privacy of medical documents being transferred into an electronic system.

Many details of the act itself are completely valid in that they effectively prevent identity theft by requiring medical nurses and doctors to have codes to access personal data.

But in the case of the Privacy Act, with all its good intentions, sometimes more harm is done then good.

The Privacy Rule specifically, as enforced initially, required that all patients give written permission via signature in order to allow another individual to access their medical information.

What this meant was that your mom couldn̢۪t call up your doctor and gain any information from him unless you signed that she was allowed to know.

For most situations this is clearly a benefit because, for example, you may be a woman on birth control who doesn̢۪t want your parents to have access to this information.

But what about emergency situations?

Imagine you are in a severe pile-up on Highway 99, leaving you unconscious. Paramedics arrive, put you on a stretcher and bring you to a Bakersfield hospital.

Realizing you haven̢۪t signed permission for anyone to know your medical information, the facility can̢۪t legally call your family or, under the rule, contact your Fresno physician.

This poses a problem: you can̢۪t speak for yourself and have no one to speak for you. The emergency doctors have no choice but to run a series of tests on you to try and discover if you have allergies to certain medications and so forth, wasting valuable time when they need to get you into surgery and operate.

These tests may only take a few moments in the ambulance, but those moments can make the difference between life and death.

Likewise, if school doctors had been able to notify family members of the Virginia Tech shooter, and if a family member of the Northern Illinois
University gunman was able to access his physician, maybe lives lost, including their own, would have been spared.

This is why psychiatric wards in particular have issues wrapping their skulls around the privacy rule. Should they maintain the privacy of a patient who sometimes can̢۪t even recognize their own name, or defy it in the name of the public good?

This is a question of ethics to me.

It̢۪s sort of like the debate about the Patriot Act: Is privacy worth more than attempts to protect the citizens of this country?

I think it̢۪s hard to decide in that case, but my personal encounters with the privacy rule in action have led me to this conclusion: privacy has limits.

Upholding the high standard of privacy in emergency situations, especially those concerning mental health, poses numerous problems.

In order for a psychiatric facility to communicate openly with a relative, close friend, or even a spouse, they would have to go to court, provide evidence that the individual is incompetent and name a conservator.

Hospitals don̢۪t have time for this process and worried family members often don̢۪t have the means for both court and care. It̢۪s also negative for the patient who may be denied proper medical care for this extended amount of time and be put through evaluation after evaluation with different experts to conclude his or her inability to speak on their own behalf.

Evaluations won̢۪t always provide the desired results because some mental illnesses have stages where one can lapse and appear fine one moment and go into a manic state the next.

Put simply, it̢۪s just too complicated to comply with the rule. It should be revised in order to incorporate such circumstances.
Until then, I plead with you: Find someone, anyone, you trust and please sign the proper documentation to secure that that individual can access your information in times of crisis.

Valerie Nevens is a freshman at Fresno State majoring in mass communication and journalism with an emphasis in print journalism. One of the few things she has in common with The Collegian’s staff columnist Benjamin Baxter is a mutual adoration of “Gilmore Girls,â€Â though Valerie also claims “Dr. Quinn, Medicine Womanâ€Â as one of her favorite shows.

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