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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Devastated Mother on February 3, 2006, at 22:22:24
In reply to Re: Suicide on Effexor » simon levane, posted by Racer on February 3, 2006, at 19:45:39
"Or even just that doctors be required to give parents information about the risks of the drugs their children are taking."
The new HIPA law does exactly the opposite. In the interest of maintaining privacy, unless children sign a release, doctors cannot talk with parents or anyone else. Depressed people are not likely to make the best decisions for themselves. My son, on the other hand, was not even asked, but even when asked, I am sure some would refuse having anyone in their family know.
Frankly, while I admit that your idea is not a bad one, I am fairly jaded at this point about anyone or anything doing anything for anyone but themselves. I think politicians (responsible for HIPA) only care about the money and the power their position can give them; I think the same is true of doctors. So who would we get to make these changes? I am just not very hopeful for this world. How exactly would anyone get this to happen? No one really cares. It is very easy to say, but doing something about it....something else entirely.
It doesn't matter, in my opinion, how old someone is--my son was 20, but he was still very much growing and developing. He was a college junior; college students are still in flux, no matter how old they are...
Good idea. Implementation? How?
DM
> > Dear Racer...
> > I really didn't answer your question better.
> > I did find a very good guide that I wish I had had long ago...
> > it is an excellent guide for parents with a child who may be suicidal.. or anyone for that matter..
> >
> > http://www.bcmentalhealthworks.ca/files/living_suicidal.html
> >
> > When I read this, I so wished that someone had given this to me before.. as it has so much excellent information. Hope it helps someone if you pass this on.
> > SL
> >
>
> And I think I wasn't all that clear in asking the question, either, so we're even on this. Let me try again, see if I get any clearer.
>
> I was wondering if you had come across any advocacy groups that were set up to that parents would be OFFERED that sort of resource as soon as a child was diagnosed or put on medication. Maybe a group trying to pass legislation that would require doctors' offices to give parents a list of local, national, and online resources that provided information about mental illness in children, and the benefits and risks of psychotropic medication for children. Or even just that doctors be required to give parents information about the risks of the drugs their children are taking.
>
> I'm not sure how old your daughter was, but if she was under 18, I am absolutely stunned that the doctor wouldn't communicate with you at all. That's terrible, since minor children are under a parent's guardianship. That just seems wrong -- her pediatrician would have told you about the risks of an antibiotic, right? Psychotropic medication should be held to the same standards as other drugs, except in very rare instances. (I'm thinking things like cases where the parent belongs to a religion that doesn't allow western doctors, or where a parent refuses to believe in depression, so creates roadblocks to that child getting help. That sort of thing, where the child's life is either in danger, or the child's quality of life is impaired, but the parent refuses to get help. And only if the child makes the move to do it -- I would NOT want to see the schools able to send kids to doctors without authorization from the parents. Basically the same sorts of things that apply to minor girls getting gynecological care without parental notification in some states.)
>
> After reading your story, as well as DM's, I just think that there should be some sort of requirement that doctors communicate risks of these drugs to parents, even if the DOCTOR him/herself does not believe that there is a risk in this case. Sort of like a black box saying "If prescribed for children under 18, risk information must be provided for parent or guardian." You know? And, frankly, since there's no way to undo the damage that has already occurred, it seemed as though you and DM might be very compelling for getting something changed, and working towards that might help a bit?
>
> Again, you have my deepest sympathy for your devasting loss, as does DM.
Posted by gardenergirl on February 3, 2006, at 22:22:24
In reply to Re: Suicide on Effexor, posted by Devastated Mother on February 3, 2006, at 21:40:52
Just to clarify for anyone else who might be reading and who might have a question about HIPAA
...you said:
> The new HIPA law does exactly the opposite. In the interest of maintaining privacy, unless children sign a release, doctors cannot talk with parents or anyone else.If you're talking about a minor child, it's the parent who would sign a consent for treatment or consent for release of information. The parent of a minor child, except in very special circumstances which vary from state to state legislation, are entitled to treatment information.
If the person being treated is of legal age, then yes, they do have the right to privacy under HIPAA laws and are the person holding that right. Parents hold the right for minor children.
I know that fact doesn't make any difference in light of your loss.
You and those who also loved your son have my sympathy.
gg
Posted by Phillipa on February 3, 2006, at 22:55:10
In reply to HIPAA rights, posted by gardenergirl on February 3, 2006, at 22:08:06
Everytime you see a doctor you have to sign and get a copy of the Hippa law. But it contradicts itself in saying they have the right to release information to a doctor or insurance company. Fondly, Phillipa
Posted by Devastated Mother on February 4, 2006, at 6:17:27
In reply to HIPAA rights, posted by gardenergirl on February 3, 2006, at 22:08:06
I know all the ridiculous rules and you're right, it doesn't make any difference. All it does is make me incredibly sad in this country where family values are supposed to be so important, that even though an FDA imposed medical instruction says that family should be warned, there is an interrupt that prevents potentially lifesaving information (in this case, that would definitely have been the case) from getting to the family, if the doctor simply doesn't bother to ask for permission to talk to family. So, no, your information doesn't help, since it gives me no new information and no indication of what might be done to improve this situation for others.
People seem to expect that expressing sympathy will just make it all better. When you lose a child, that isn't going to happen, especially when it was TOTALLY preventable.
DM
Posted by Devastated Mother on February 4, 2006, at 6:19:22
In reply to Re: HIPAA rights, posted by Phillipa on February 3, 2006, at 22:55:10
Particularly in the case of mental health, it seems to me that no bureaucrat actually engaged their minds before writing this legislation. It angers me, and makes me very disappointed in both the legal system and the medical system.
Posted by Devastated Mother on February 5, 2006, at 9:51:39
In reply to Re: Suicide on Effexor, posted by Devastated Mother on February 3, 2006, at 21:40:52
HIPAA - can someone explain to me why there are not exceptions to the law allowing doctors to inform family when the FDA black box label clearly says that family should be informed? Do they expect that the depressed patients will inform family members? Do they really not see the Catch 22 they have created?
Devastated Mother
"Or even just that doctors be required to give parents information about the risks of the drugs their children are taking."
>
> The new HIPA law does exactly the opposite. In the interest of maintaining privacy, unless children sign a release, doctors cannot talk with parents or anyone else. Depressed people are not likely to make the best decisions for themselves. My son, on the other hand, was not even asked, but even when asked, I am sure some would refuse having anyone in their family know.
>
> Frankly, while I admit that your idea is not a bad one, I am fairly jaded at this point about anyone or anything doing anything for anyone but themselves. I think politicians (responsible for HIPAA) only care about the money and the power their position can give them; I think the same is true of doctors. So who would we get to make these changes? I am just not very hopeful for this world. How exactly would anyone get this to happen? No one really cares. It is very easy to say, but doing something about it....something else entirely.
>
> It doesn't matter, in my opinion, how old someone is--my son was 20, but he was still very much growing and developing. He was a college junior; college students are still in flux, no matter how old they are...
>
> Good idea. Implementation? How?
>
> DM
>
> > > Dear Racer...
> > > I really didn't answer your question better.
> > > I did find a very good guide that I wish I had had long ago...
> > > it is an excellent guide for parents with a child who may be suicidal.. or anyone for that matter..
> > >
> > > http://www.bcmentalhealthworks.ca/files/living_suicidal.html
> > >
> > > When I read this, I so wished that someone had given this to me before.. as it has so much excellent information. Hope it helps someone if you pass this on.
> > > SL
> > >
> >
> > And I think I wasn't all that clear in asking the question, either, so we're even on this. Let me try again, see if I get any clearer.
> >
> > I was wondering if you had come across any advocacy groups that were set up to that parents would be OFFERED that sort of resource as soon as a child was diagnosed or put on medication. Maybe a group trying to pass legislation that would require doctors' offices to give parents a list of local, national, and online resources that provided information about mental illness in children, and the benefits and risks of psychotropic medication for children. Or even just that doctors be required to give parents information about the risks of the drugs their children are taking.
> >
> > I'm not sure how old your daughter was, but if she was under 18, I am absolutely stunned that the doctor wouldn't communicate with you at all. That's terrible, since minor children are under a parent's guardianship. That just seems wrong -- her pediatrician would have told you about the risks of an antibiotic, right? Psychotropic medication should be held to the same standards as other drugs, except in very rare instances. (I'm thinking things like cases where the parent belongs to a religion that doesn't allow western doctors, or where a parent refuses to believe in depression, so creates roadblocks to that child getting help. That sort of thing, where the child's life is either in danger, or the child's quality of life is impaired, but the parent refuses to get help. And only if the child makes the move to do it -- I would NOT want to see the schools able to send kids to doctors without authorization from the parents. Basically the same sorts of things that apply to minor girls getting gynecological care without parental notification in some states.)
> >
> > After reading your story, as well as DM's, I just think that there should be some sort of requirement that doctors communicate risks of these drugs to parents, even if the DOCTOR him/herself does not believe that there is a risk in this case. Sort of like a black box saying "If prescribed for children under 18, risk information must be provided for parent or guardian." You know? And, frankly, since there's no way to undo the damage that has already occurred, it seemed as though you and DM might be very compelling for getting something changed, and working towards that might help a bit?
> >
> > Again, you have my deepest sympathy for your devasting loss, as does DM.
>
>
Posted by Racer on February 5, 2006, at 17:35:43
In reply to Re: Suicide on Effexor, posted by Devastated Mother on February 5, 2006, at 9:51:39
> HIPAA - can someone explain to me why there are not exceptions to the law allowing doctors to inform family when the FDA black box label clearly says that family should be informed? Do they expect that the depressed patients will inform family members? Do they really not see the Catch 22 they have created?
>
> Devastated Mother
>HIPAA was not created by, nor for, doctors. In fact, it actually gives most people LESS privacy, because it allows insurance companies and employers so much access.
HIPAA, like any other legislation, was created and passed by legislators. If we don't like it, the only thing we can do is take steps to have the legislation changed, by contacting our local representitives and expressing our concerns. That's why we vote.
Posted by gardenergirl on February 5, 2006, at 17:50:32
In reply to Re: Suicide on Effexor, posted by Devastated Mother on February 5, 2006, at 9:51:39
> HIPAA - can someone explain to me why there are not exceptions to the law allowing doctors to inform family when the FDA black box label clearly says that family should be informed?
There are exceptions.
If a patient is in immediate danger of self-harm, the doctor or other provider is allowed to break confidentiality in order to keep that patient safe.
This breaking confidentiality must be the minimum necessary to accomplish safety. For example, it may include telling police, family, ER personnel, etc. about the patient's care, diagnosis, and status in order to keep the person safe.
All of this depends, of course, on the doctor or other provider being AWARE of the imminent danger. And imminent means that the person has a plan and intends to carry it out, and has not responded to attempts to arrange for their safety voluntarily.
HIPAA requires phsycians or other providers to disclose when private health information (PHI) is disclosed, so in the above scenario, in order to comply with HIPAA, the person CAN disclose minimally necessary information and must document said disclosure.
gg
This is the end of the thread.
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