hungry hungry hipaa
It’s been a while since we’ve spoken, so I thought I’d re-initiate posting with a contentious issue that I am sure to misrepresent, which I’m sure will be fun for everyone. Yes, that’s right, I want to talk about Steve Jobs’s shiny new liver, or rather, I want to talk about the talking about of Steve Jobs’s liver.
On the business side, many people believe that in failing to disclose the severity of his illness, Jobs misled Apple’s shareholders. This is, of course, a load of crap. Were Jobs suffering from Alzheimer’s, early onset dementia, Huntington’s disease, or any disorder that might plausibly affect his decision-making skills, then sure, he should probably let the world know, but no CEO has ever had to do anything like this (and notice that I use the words “probably” and “should,” not “certainly” and “must”). Moreover, Jobs’s liver problems are about as relevant to his decision-making skills as a broken leg. Should Jobs send out a bulletin whenever his eczema acts up? After all, it could make him grumpy, and thus exacerbate his legendarily controlling attitude. Ultimately, it doesn’t matter. Whether it’s eczema or pancreatic cancer, the only person with the legal authority to talk about Steve Jobs’s health is Steve Jobs.
Just because some idiot at the New York Times whips out an ominous-sounding phrase like “dereliction of duty,” that doesn’t mean he’s talking about a real thing. I don’t know anything about business law, but I’m certain that federal patient privacy laws trump misappropriated and ill-defined military terms. Speaking of patient privacy laws, let me introduce you to something I do know about: the Health Insurance Portability and Accountability Act (HIPAA). Whereas terms like “secrecy” and “dereliction of duty” are slippery and vague, HIPAA is anything but. The rules and regulations protecting your (and Steve Jobs’s) privacy go on for miles and miles, and they all make it crystal clear that Steve Jobs is obligated to no one when it comes to information about his health.
How strict is HIPAA? Back when I worked on a brain injury research project and regularly had to read the medical charts of new admissions to determine their eligibility for our study, my exact instructions were to stop reading a chart immediately if I determined that a patient was ineligible. Not one syllable of extra information about an ineligible patient was to enter my brain, no matter how interesting the case (and we did have a couple of House-like enigmas now and then). Likewise, signs in elevators and corridors remind medical staff to avoid discussing cases in public areas. Dr. Phil nearly had a civil suit on his hands when he stupidly blabbed to the press after a brief visit to Britney Spears’s hospital bed. And don’t get me started on the unholy mess that will descend upon you if you have a patient sign an expired consent form (never mind that the new consent forms are identical to the expired ones).
The point is that patient privacy is a sacred right, and a tightly guarded one at that. To insinuate that Jobs is obligated to share the details of his health with his shareholders simply because they’ve thrown some money at his company is absurd. Let’s follow this line of reasoning to its logical conclusion. Suppose I decide to blow some cash on a single share of Apple’s stock. Congratulations, me, I’m a shareholder! So do I now deserve access to Jobs’s medical information, all for the low, low cost of $135.40? Apparently yes, according to the “dereliction of duty” crowd.
The media are interested in Jobs’s health because he is one of technology’s visionaries and perhaps the world’s most charismatic businessmen, arguably one of the few real business celebrities in the world. He is famous, and the media are curious about him. HIPAA, again, makes no allowances for someone’s curiosity. It is hypocritical of the Wall Street Journal to insinuate that Jobs might have used his celebrity status to jump to the front of the transplant line, while at the same time affording him this ridiculous, speculative coverage because he is a celebrity. Jobs’s desire to remain quiet about his private health is not an affront to free speech; it’s a human right.
So both the muckrakers and the robber barons can kindly eat it.
So it’s a human right to lie and cover up? Interesting twist on HIPAA, which is an artificial construct and not something inbred in human genes. Anyway, the truth will come out when Jobs dies, as it will with Michael Jackson. It’s better to say it’s human nature not to reveal the dirt about oneself and to always look like a saint rather than a sinner.
Gary: A person’s medical history is private, but not by definition “dirt.” As for HIPAA being an “artificial construct,” well, yes, but so is our right to free speech (it’s far easier, and far more common in history, for the ruling class to suppress its detractors). Shall we do away with that as well?