Kicked out of doctors office for refusing to allow them to take pictures. is this legal? I moved this post off the medical stack exchange as it was flagged as off topic so hopefully this is the proper place for it. I have a problem with a thumbnail that has been lingering for months now and I finally decided to make an appointment with a dermatologist. I called, made the appointment, filled out the paperwork, etc. I showed up for the appointment and all was normal, scanned my drivers license, took my co-pay and confirmed my medical history. They called my name and took me back to the room and the assistant asked to take a front and side picture of my face. I noticed a screen on the wall showing before/after shots of patients facial problems so I told the assistant that I was there for my thumb not any facial issues and she said it was for their records. I said I didn't mind if she took a picture of my thumb but that I didn't see any reason to take pictures of my face. Her tone immediately changed and she quickly finished the interview and left the room. A few minutes later a women walked in and introduced herself as the office manager and explained to me that it was their policy to take pictures of patients for "security reasons" and that I would be refused service if I did not comply. I politely told her I understand she has to follow her policies and asked for a refund of my co-pay which she provided then I left the office. Can a doctor legally do this? Is this a violation of HIPAA? If so where would I file a complaint?
The "Privacy Rule" (45 CFR Part 160 and Part 164, Subparts A, E) don't forbid this. Sect. 164.502 states the general rule: (a) Standard. A covered entity or business associate may not use or disclose protected health information, except as permitted or required by this subpart or by subpart C of part 160 of this subchapter. "Health information" is defnes in part 160 as any information, including genetic information, whether oral or recorded in any form or medium, that: (1) Is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and (2) Relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual. Your picture would not constitute health information (and anyhow, they are allowed to gather health information, just not freely disseminate it – the pictures on the wall were presumably with permission). There is no general law (which would be state law) against taking a person's picture (though commercially exploiting someone's picture would require permission, via the concept of personality rights), and it is directly required in a number of instances (for identification purposes – school ID, driver's license, passport, voting in some states). It is an unusual requirement and since they scanned your driver's license it is especially inexplicable. Assuming that this is just a story they tell all patients because they want before and after pictures (which you would have to consent to, if you didn't already in one of those "sign here" flurries), saying that this is for "security purposes" would be untrue, but I don't think it's actually illegal. Taking but not using a photo would not cause you harm, so if you had let them take the picture, there would not be a basis for suing. If they use it for advertising without permission, that would be a problem.
It would merely be a &quot;jerk move&quot;. HIPAA only applies to &quot;covered entities&quot;: Healthcare Providers Health Plans Healthcare Clearing Houses (i.e. Paying for your health care) Business Associates of the Above) Source: CDC page on HIPAA
In general in the US, anyone may photograph anyone else if they are all in a public place, although in some states such a photo may not be used commercially without permission, which must often be paid for and may be refused. It is unusual for police to photograph people on the street, but they might want to document who was present at a particular place and time. They can do so, but I am not at all sure that they can prevent a person from covering his or her face, or turning his or her back, or charge a person who does so with obstruction. I don't think so. Under some circumstances in the US police may ask a person for identification, and may charge a person who refuses to provide it. This varied from one state to another, and usually depends on the specific circumstances. (If a person is driving an automobile, police may demand to see a driver's license, for example.) Unless a police officer puts a person under arrest, the officer has no general right to control that person's actions, beyond instructing the person not to interfere with ongoing police work. I do not think an obstruction charge would hold up for covering one's face or turning away in the absence of an arrest.
I assume these are digital photos that were electronically transferred (not prints physically delivered). If they were prints physically delivered, he owns those prints, since you used to own them but you unconditionally transferred ownership to him by giving them. No backsies under the law. The photos are protected by copyright law, which means that the person who took the pictures has the exclusive right to make copies, disseminate them, and authorize making copies. In order for anyone to make a copy, they need permission – a license – from you. In the world of pre-planned business deals, the copyright holder writes up a document granting B some right to use the protected material, which typically means "you can install it on your various devices but may not give copies to others". In this case, however, you didn't create an explicit written license. So if this ends up in court, the question is what implicit license you granted. The courts will not decide that you granted him the license to unrestrictedly sell or give away copies of the protected material. The most likely outcome would be that he can only keep his copy, i.e. he will not be forced to erase the copy that you sent him. What the courts would do is try to discern what license you most likely intended to grant to him. There is a provision in copyright law that allows a licensee to make backup copies of a computer program (17 USC 117), but a digital photo is not a computer program. So the lifespan of the copy that you sent would be the lifespan of the phone (I assume) that you sent it to. Since actually using a digital photo technically requires making a copy (from disk storage to computational memory), there is a legal direction (dead-end) that you could go where the photo could exist on the phone, but never be opened again. Again, the courts would have to discern what license you probably intended w.r.t. ever opening the photo – obviously you intended that the file could be opened / viewed any number of times. You could argue that the license which you granted was conditional, i.e. "you can have and use these pictures as long as we are a thing", but establishing that this was part of the license would be tricky. Free digital content often has some "as long as" condition attached to it, i.e. "you can use this program as long as you are affiliated with University of Whatever". I don't consider a conditional license to be a ridiculous interpretation, on the other hand the particular court (judge) might decide that people who sext should be forced to live with the unpleasant consequences of their decisions. If we exclude such a line of thinking, I don't see a compelling counter-argument that your ex-partner inequitably loses a right by construing the license as conditional. I don't know if there is any case law that addresses this: at any rate, copyright law would severely limit what he could do with the pictures (the tort "invasion of privacy" also limits dissemination).
The tort for this kind of activity is called public disclosure of private facts, and almost every U.S. state recognizes that this tort is invalid under the First Amendment in the absence of a legal duty not to disclose of the type existing between an attorney and client, or a psychotherapist and a patient, or a contractual non-disclosure agreement, that does not exist between roommates. There is nothing illegal about your roommate's conduct. Your best move at this point is to take responsibility for your own conduct, to repent and to convince the world that you're doing your best to get on the straight and narrow going forward. If your former roommate insisted on payment for not disclosing the information, that would be extortion, but there is nothing wrong with going ahead and disseminating it without trying to obtain something of value from you for not doing so.
http://www.healthinfoprivacybc.ca/confidentiality/when-can-and-cant-they-tell-others is a pretty good summary. Different rules apply to private practices than public clinics and hospitals. I will assume that the clinic on campus is private. This is a summary of the summary about who your information can be shared with: Health care professionals can share information within your "circle of care". Specifically, they are allowed to assume your consent to this but you can explicitly withdraw that consent. This would include doctors within the same practice. Admin staff can access your information for administrative purposes. Anyone you have authorised them to share it with e.g. relatives, friends etc. The Medical Services Plan for billing and admin If you are unable to drive If there is suspected of child abuse If you are wounded by a gun or a knife If you are a danger to others For your specific questions: I asked about it and they said it's confidential, but confidential to the clinic. Correct, unless you explicitly revoke this. the counselling department can share information with the doctors This is tricker, these people may be either within your "circle of care" or they may be part of the same organisation. Notwithstanding, councillors are not doctors and are governed by the everyday laws related to confidentiality i.e. information given in confidence is confidential and everything else isn't. If you are told the limits of the confidentiality i.e. they tell the doctor, then those are the limits unless you renegotiate them. he would know I only have one kidney? Well you said "the counselling department can share information with the doctors" and this would require the information going the other way i.e. the doctor sharing with the councillor. Even if this type of sharing was OK in general (and I'm not sure it is, see above); the information shared should only be what is required for the councillor to do their job - the number of kidneys you have is probably irrelevant to this. What laws apply to situations like this where confidential information in one entity (medical office) decides to share it without the consent of the patients to another entity (the counselling dept.)? Well, we are not sure there are 2 entities: legally there may only be 1 - the university. Anyway, the laws are the Personal Information Protection Act and common law (Smith v. Jones, [1999] 1 SCR 455)
TV shows like COPS will have the arrestees/suspects/bystanders/victims sign a waiver to appear on the show, along with anybody else that they film in the process, otherwise the faces will be blurred, or removed from the show entirely. Additionally you can tell the camera crews that they are not allowed in your home. If they do enter your home without permission, you can sue them for trespassing. It should be noted that those shows are often edited for drama, and as such seem much more dramatic than it is. The film crews may spend weeks or more (400 hours of video) just to get enough "good stuff" for a 22 minute episode, and then make it look like it all happens over the course of an evening. As for the moral/social acceptance of a lack of privacy, that question really isn't on-topic here. This should be the same for any other "COPS-like" TV/youtube show, but there are some shows out there that don't take the rules as seriously as others. Those usually operate under the "who we are filming probably can't afford a lawyer" mentality so they keep going until they get sued.
As a preface, while the best course of action isn't always clear and the reality of implementing some solution is often rocky, the bipolar diagnosis situation you describe is probably the single most common situation in which legal arrangements must be made for an adult child, and is almost as common as the need for children to make legal arrangements for the care of their declining parents. You aren't the only one going through situations like these. Probably 0.5%-2% of people in any given area experience bipolar, usually starting in adolescence or young adulthood, and difficulties managing it of the kind that you describe are the rule and not the exception. Also, just ignoring the problems you describe is a very bad idea. Premature death either from suicide or bad judgment related to the bipolar diagnosis is all too common in these situations. It is serious business, not something that should be thought of as bad character, or futile to do anything about, or blameworthy. It just is, and if someone doesn't do something when the plan gets off course, serious consequences often follow. There are really several intertwined issues present here. Realistically, given the nature of the concerns expressed, a limited guardianship may be necessary to accomplish the goals expressed. What Are Medical Powers Of Attorney? A healthcare or medical power of attorney gives the person who holds it (who is called an "agent" or "proxy") the authority to make medical decisions for someone called the principal (i.e. John Smith) when the principal lacks the capacity to give informed consent at that very moment to do so. This is because a power of attorney is an inherently revocable document expressing the wishes of the person writing it. You generally can't bind yourself in the future without court approval or a contractual relationship with a third party which a power of attorney is not. It isn't uncommon for medical personnel to decide on the spot when to and not to listen to someone with a medical power of attorney based upon how mentally competent the patient seems at the time on a decision-by-decision basis. For example, they might defer to the medical power of attorney agent when the patient is unconscious or heavily drugged, and listen to the patient when the patient is conscious, not drugged, and not acting erratically. Parents, incidentally, do not automatically have this authority, nor do spouses. A medical POA is a document that allows the agent to say "yes" when the patient (i.e. John Smith) cannot. Another name for a document that is very similar and sometimes used is a "health care proxy." It would typically cost a few hundred dollars to $1,000 to have a medical power of attorney drawn up after discussing the situation and the principal's needs in a meeting with a lawyer and might take an initial meeting and then a second one at which the document is signed after it is prepared following the initial meeting. Other lawyers might manage this in a single meeting and draft it while you wait. If all you need is a power of attorney, don't be penny wise and pound foolish by doing it yourself, unless the form is provided to you by the health care provider you will spend most of your time dealing with and they prefer their own form. Otherwise, the likelihood that you will have to pay more to a lawyer later cleaning up your own mistakes probably exceeds any money that you will save. Other Kinds Of Authorizations Many medical providers will allow someone to act on behalf of a patient in matters other than matters that call for the kind of medical decision that would normally require the informed consent of the patient, even when the patient is not manifestly incapable of making medical decisions at that very moment. This could simply be a note in the file that the patient has given that person authority to do so, it could be a written authorization to access HIPAA protected personal health information of the patient, and it could be a variety of other things (e.g., authority to make financial arrangements). Some of this is often incorporated in the same document as a medical POA. Picking Up Controlled Substances A Medical POA may, or may not, necessarily be sufficient to authorize someone to pick up a controlled substance on behalf of a patient if the patient is physically able to do so, without the presence of the patient. I don't know what the true rule of law under the controlled substances acts and pharmacy regulation is, but I do know that practice in real life varies quite a bit. The best practical solution to the issue of picking up controlled substances would be to ask the usual pharmacist what they require and to comply. (A legal guardian would generally have the power to pick up controlled substances for a ward.) Guardianships and Limited Guardianships What Is a Guardianship? A guardian of the person is someone appointed by a court who has the authority to make medical decisions and other personal life decisions for their ward (i.e. John Smith), even contrary to their apparent stated wishes. A guardian has the authority to say "yes" and also to say "no" to the expressed wishes of the ward, overruling the ward. A guardianship of an adult can be general, or can be limited on a customized basis. A guardian must be appointed by a court with jurisdiction over these cases, usually in the county where the ward resides. But, a guardianship can be requested by the ward as opposed to contested. Realistically, a court would be unlikely to grant a full guardianship or a contested guardianship in these circumstances, but might grant a limited guardianship with the consent of the ward in these circumstances. The parents and possibly any siblings, would have a right to notice of the proceedings and to object or to seek to be appointed instead. What Process Is Involved In Having a Guardian Appointed? This would realistically be a proceeding that should ideally involve a specialist lawyer (with experience in mental health or elder law and guardianships) and at least one medical professional's statement (probably a treating psychiatrist or psychologist). There would also probably be a court investigator or guardian ad litem appointed at the ward's expense, to confirm that the facts represented in the petition to have a guardian appointed really reflect the ward's intent. Usually, a proposed guardian selected by the adult ward during a lucid interval would have priority for appointment. The medical professional and lawyer should be able to provide good suggestions regarding what the scope of the limited guardianship needs to be, although don't ignore or fail to give full credit to your own layperson's practical understanding of the situation either. The guardian would have to provide information to the court in connection with the petition showing eligibility to serve (e.g. criminal record check, credit check, CV, nomination by ward). Often the guardian would have to demonstrate good intentions towards the ward in some way, especially if the guardian is a third party and not someone who serves as a guardian as a livelihood. Some courts would require the guardian to have insurance for liability in connection with the task or a surety bond up to some dollar amount. The final decision would usually be made in an in-person hearing at which the ward, the proposed guardian, the proposed guardian's lawyer, the medical professional, the guardian ad litem or investigator, the judge, a court clerk, a court reporter, and any family members who chose to appear (with their lawyers, if any), were present. If the guardianship was granted, perhaps with modifications requested by the judge to the terms of the guardianship, then the Court would issue what are called "Letters" that formally appoint the guardian to the post. Once appointed, the guardian would have to file periodic status reports with the court and would also be subject to the court's jurisdiction in the event of any future dispute regarding the guardianship, or any allegations of misconduct by the guardian, or any circumstance that requires court approval such as a change in the terms of the guardianship or in the person serving as guardian. The procedural details I am describing are approximate and aren't necessarily up-to-the minute correct, and might vary somewhat even from court to court within California under local rules and customs of practice; but they give you a gist of what the process would be like if it is working properly and with best practices. Typically, this might cost $3,000 to $10,000 all in for an uncontested proceeding, and many times that much in the event of a contested attempt to have a guardian appointed. Health Insurance Eligibility I'll defer to someone else's answer regarding health insurance eligibility, as I don't have time to look into that at the moment. My instinct is that this wouldn't be a problem in any case except a guardianship and probably wouldn't be a problem even in a case with a third party guardian, but I can't confirm that without doing research.