Is it legal for a hospital to disclose details of one's forced hospitalization hearing to a family member?

Question

My mother had me involuntarily admitted in NY State, and the hospital deemed me fit for discharge. There were delays and during that time my mother called in protesting my scheduled discharge. My discharge was cancelled.

I had an administrative hearing scheduled in two days, with a court hearing pending its outcome scheduled for two additional days after that.

I discovered that my mother knew all the details of the court hearing. My lawyer said that it would be illegal for the court to have released these dockets to anyone as they are confidential, but it wouldn't be a breach of medical privacy laws for the hospital to release the fact and details of such a hearing to my mother, because it isn't medical information.

I then questioned his answer with the challenge that if I was to call the hospital tomorrow asking for details of all of the upcoming patient hearings this month, I'm guessing that they wouldn't indulge my request, and he agreed, but he said that they would give it to someone's mother, and that this would not be a breach of medical privacy laws, however subjectively morally repulsive we may respectively find it. Firstly, is my lawyer correct in that, even while the court keeps private the information in these dockets, the hospital is entitled to share it with whomever they may so choose?

But I still cannot bridge this gap in my understanding: am I to understand that if they were to indulge my request, that they would not be committing any breaches, but that they would be guided by their own political incentives as well as moral compasses to refrain from doing so? Is my lawyer right here? Is revealing this information to my mother legal? (I was an adult from well before the time of admission, and my parents had waged a failed bid in another state to have me designated gravely disabled which the court rejected after ordering a so-called adulut protective services investigation, so there should have been no ambiguity as to my fitness to exercise adult legal sovereignty, even if one would otherwise argue that it might be questioned until a court could decide.

This begs the corollary question in my mind then, of the basis of why we may find disclosing these things to her so morally repulsive as we do: the answer of course, being that she was medically abusing me by deceiving and unduly influencing the medical institutions to assist her wickedly pathological agenda, that of Munchausen Syndrome by Proxy. Does a private psychiatric hospital in the State of NY, then, have any duty of care to its patients to pay due diligence and care to screen for cases which might be matters of Munchausen Syndrome by Proxy or other Medical Child Abuse, despite the financial benefits to their bottom lines of turning a blind eye?

Is my lawyer right here? Is revealing this information to my mother legal?

Does this violate their duty of care if my mother knowing this information would be bad for my mental health?

Answer 1

The US Federal HIPAA law applies only to the confidentially of medical information. Given that the mother in this case already knew that the child had been admitted, and the general diagnosis, no medical information was released by revealing the date and location of the hearing. If a stranger had asked a similar question, any answer would reveal that a named person was a patient, and something about that person's diagnosis. That would be a HIAPA violation, as I understand the HIPAA rules.

I have not found a separate NY state law requiring additional protection on revealing such information.

A family member is quite probably a legitimately interested person, and has a right to attend such a hearing.

I have not found the specific NY state rule makign uch hearing times confidential. In many US States, information about the dates, times, and parties to most if not all court hearings is a matter of public record, and any person has a right to obtain this schedule.

There is a general assumption that family members are potentially helpful to petitioners/patients at such hearings, and that it is helpful to hear from such family members. Obviously, this is not always the case.

A hospital does have a general duty of care towards its patients, and is supposed to work for their best interests, as its staff understands those interests. Whether it would have a specific duty to consider Munchausen Syndrome by Proxy would depend on the specific facts. That can be, as I understand it, a hard diagnosis to make. I believe that it is also much rarer in practice than in popular report.

It is unusual that a hospital has a significant profit motive to prevent the discharge of any particular patient. If one patient is discharged, another is likely to be admitted, and the hospital' finances will not, in general, be much affected. Of course that may be particular cases where this is not the situation.

Answer 2

Probably the best solution is for you to read the relevant law, [MHY Ch. title B part 9, filling in the exact sequence of events (who did what, when). Your description suggests an involuntary admission, so you would start at §9.27. There is a statutory list of individuals who can initiate this process, which includes your mother, or "the nearest available relative". If you are certified for admission, §9.29 requires notification to be given to various people including "the nearest relative of the person alleged to be mentally ill, other than the applicant". This statute does not require notifying the applicant, which I suspect follows from a separate part of NY law.

§9.31 allows the patient, friend or relative to apply for a hearing prior to the expiration of the 60 days, and you may request a specific county for the hearing. Then,

Such hearing shall be held in the county so designated, subject to application by any interested party, including the director, for change of venue to any other county because of the convenience of parties or witnesses or the condition of the patient upon notice to the persons required to be served with notice of the patient's initial admission.

The (initial) applicant is by definition an interested party, thus the applicant must be notified of the request for hearing. With that out of the way, notices are filed with the court – previously, the court was not involved. The reason why you can't go on a fishing expedition to get all of the discharge requests is that you are not an "interested party", in the legal sense. It's hard to explain exactly what a legally "interested party" is, but it's not just "someone who is curious". Then, as part of the court hearing, determinations of fact are to be made that in part connect to your family, viz

If it appears, however, that the relatives of the patient or a committee of his person are willing and able properly to care for him at some place other than a hospital

which is then a path by which the court could involve your mother.

The law states that "the court shall hear testimony and examine the person alleged to be mentally ill", and does not impose any statutory limits on who may provide testimony. Thus if the court deems that your mother's testimony is relevant, it can notify your mother and require her to testify. The proceedings are then sealed, and "shall be exhibited only to the parties to the proceeding or someone properly interested, upon order of the court".

So the courts would not release any legal information to random people as part of e.g. a public record request, but properly interested parties can be notified including being subpoenaed.