What happened to HIPAA in the 24th century?!
Posted by DustBunnie702@reddit | TNG | View on Reddit | 70 comments
So much for “progress”. I’m watching “The Child” and in our very first encounter with Dr. Pulaski, the entire senior staff is in the conference room where she announces “Counselor Troi is pregnant.” What follows is everyone discussing her pregnancy and what to do about it as if she’s not even in the room. Worst of all is Riker: “Who’s the father?” It’s Nunya. As in Nunya Business.
In pretty much every single medical oriented episode, all semblance of personal privacy is completely out the window. There’s Dr. Crusher on the bridge telling everyone within earshot about Barclays’s latest hypochondriacal escapade, or on the comm system broadcasting it to the entire ship. It’s not just the Enterprise, it’s all the doctors in the TNG-verse. I get that the AUDIENCE needs to be informed, and it’s probably more efficient for the writers to just tell everyone at the same time. But it takes me out of the scene when I’m wondering what the heck happened to HIPAA in the 24th century? Have we “progressed” to the point where doctor-patient confidentiality is obsolete?
Side note: if the Child was an entity who impregnated Counselor Troi, creating an exact copy of her DNA, why is it a boy and not a girl?
scully360@reddit
Well, it's a TV show and it was part of the plot device. Pretty boring show if the entire scene was shut down immediately because of HIPAA.
ElectricPaladin@reddit
Re: Troi, she isn't really a counselor. She's a political officer. Her job is counseling-adjacent, in that she is mostly on the lookout for emotional instability that stems from an individual's inability to manage the Federation's cooperative, money-free way of life. Too much aggression or selfishness can be a dangerous problem. And, honestly, that isn't even creepy - do you want some agro throwback acting like a militaristic 20th century maniac when he's at the helm of a starship with enough firepower to wipe a city off the face of a planet? I didn't think so.
Now, it's a bit weird when Troi blabs about it in front of the entire bridge crew, sure.
But... Barclay's privacy isn't her main concern. If he's become unstable, the captain needs to know about it. Troi is a nice person and she is trained as a counselor, so she would much rather help Barcalay grow and recover than have the captain relieve him of his duties and cashier him out of Starfleet... but she knows what her job is.
Sea_Violinist3328@reddit
She is totally a counselor.
She graduated from Starfleet academy with a degree in psychology. We literally see her conducting real counseling sessions with crew members. Grief counseling no less.
She’s just a straight up counselor.
And yeah, they use her on political missions but that is the aspect that is adjacent to her job, not the other way around.
AlteranNox@reddit
It's also largely due to her empathic abilities more than her position.
Sea_Violinist3328@reddit
Let’s not kid ourselves friend - Troi’s empathic abilities rarely did anything productive other than make her a victim of psychic attacks. I can’t think of one situation where her abilities actually made a difference other than maybe Star Trek Nemesis. She originally could tell if people were lying and then the writers dropped that fast since they realized it would fuck up like every plot.
Basically her her entire thing was “I can sense something, but I can’t tell what”.
Helpful.
AlteranNox@reddit
This isn't biased troi bashing or anything lol
Sea_Violinist3328@reddit
So I can’t even begin to tell you how absolutely fucking wrong you are about me “loathing” female characters.
I have been a Deanna ride or die since I was a little boy. Beverly Crusher is my all time favorite diva, above Britney, above Jean Grey, above RuPaul. When I was in FIRST GRADE I remember being pissed that the women in Star Trek got so few episodes focused on them.
I have a signed photo from Marina Sirtis. If I wasn’t gay, she’d be my wide. PeriodT.
I still don’t think her empathetic powers really did much in the series. However, I think Deanna as a character did and I fucking love her.
So tell me again how I loathe female characters boo boo? Maybe check your ignorant ass at the door. Sort of cringey how you try to tried to read me without knowing me. barf
ElectricPaladin@reddit
I would argue that she's trained as a counselor but her actual job on the Enterprise combines therapy and monitoring the crew for dangerous instability.
Sea_Violinist3328@reddit
Correct, as the ship’s counselor she is in charge of the overall mental health of the crew and would be monitoring them for things like PTSD, depression, paranoia, insanity, Etc Etc.
Darmok47@reddit
Zampolit Troi? Like in The Hunt for Red October?
ElectricPaladin@reddit
I guess so.
Soththegoth@reddit
Don't you think the officers should know a crew member war raped by an alien who's intentions are unknown?
ThoughtfullyLazy@reddit
HIPAA was an American law passed in 1996 of our timeline. In Star Trek the Eugenics Wars where Khan and his followers took over a large port of the planet happened from 1992-1996. The timeline had a lot of retcons but the late 20th century to mid 21st century was filled with the Eugenics wars and WW3. I doubt the US was too focused on patient privacy rights, whatever part of it still existed.
If anything was passed or survived long enough it was gone by the late 21st century according to Q… “This is a court of the year 2079, by which time more rapid progress had caused all United Earth nonsense to be abolished.”
DVariant@reddit
Hey WW3 could still happen
pfpants@reddit
It's gone, obviously. Otherwise they'd still be using fax machines.
Petrostar@reddit
In the noble bright future of Star Trek people have evolved beyond such petty hang-ups.
unknown_anaconda@reddit
Remember the majority of characters are members of Starfleet, a quasi military organization. A certain amount of medical privacy is sacrificed in such an organization. Anything that could potentially jeopardize the mission, ship, or crew is fair game. They weren't discussing Troi's pregnancy because she got knocked up from a one night stand. She was impregnated, without consent, by an unknown entity, with unknown and potentially harmful intent.
Candor10@reddit
We're not privy to the conversation Pulaski had with Troi. Troi likely consented to having her condition discussed with the senior staff, especially due to the unusual nature of it and possible risks to the ship & crew.
WhiteSquarez@reddit
Even now,, with HIPAA in existence, it doesn't always apply in military scenarios. Military commanders are exempt from being barred from accessing medical information about troops under their command because that information is necessary for making a determination about unit readiness.
Character_Unit_9521@reddit
That's because it was written with 1980s and 1990's by non medical professionals.
unquietmammal@reddit
HIPPAA is a terrible idea in a confined space ship. Really HIPAA is a shitty law medical privacy is ridiculous and the streamlining doesn't work great either. But generally all the episodes that violate it seem to be among senior staff or mission critical staff which would be exempt. But the real kicker is would be my favorite line as to Picard being bald. Why haven't they cured baldness, in the 23rd century they don't care about baldness.
I take that to mean that if you have a problem medically people are supportive to you, instead of selfish assholes. Reg has holoaddiction and autism, until it effects his duties it's basically his choice, and we all fuck the Troi/Data holo, and Geordi apparently married Leah.
Tasty-Fox9030@reddit
HIPAA is a United States thing. The Federation is a utopia and the US healthcare system is what's leading up to the Bell Riots and Khan Noonian Singh being seen as a NOT SO BAD guy in comparison to some of his contemporaries.
Now having said that, the Enterprise is not a civilian facility, it's a starship on an extended exploratory mission. I would assume no one on board has ANY medical privacy beyond it being something that isn't casually discussed. Epidemics, reduced crewman performance including mental health issues, the actual population numbers of the ship, are ALL everybody's business.
pornthrowaway92795@reddit
First principles;
Why is HIPAA needed? Because people can be jerks.
In the 24th century, humanity has evolved to be better people. That’s the core thesis of the show.
So you don’t need rules that were created to stop people from being jerks, because they won’t.
There’s no shaming, no denying promotions, etc.
thirdeyefish@reddit
I mean, it is the military. Wasn't this in a senior staff meeting?
CoffeeJedi@reddit
I feel like HIPAA might not apply to Starfleet officers serving on a starship. The senior staff must know all medical issues of the crew that could impact their performance or the safety of the Enterprise. Private individuals are one thing, but you give up some rights when you join a quasi military operation like that.
ZedPrimus84@reddit
Yea, it's probably fairly important information if someone goes on an Away Mission and comes back with some illness that the Transporters couldn't purge out. What amazes me far more than the lack of HIPPA (which I think is an American thing anyway and earth is united under a new planetary government by the 24th century), Is that everyone who goes to a new planet for the first time doesn't spend a week in quarantine. They just go "Oh the transporter didn't flag anything. He must be fine" which half the time leads to Space Plague spreading throughout the ship.
frygod@reddit
Without insurance companies and employers to discriminate against people for prior health conditions, laws like HIPAA were no longer needed. Also the USA ended with WWIII.
moktira@reddit
I can't be the only person who has no idea what HIPAA is, googling it I see "Health Insurance Portability and Accountability Act" which can't be right?
SaltDeception@reddit
That is indeed what we’re talking about, specifically the rules surrounding the disclosure Protected Health Information (PHI).
moktira@reddit
As a non-American, can you summarise this? From context I assume something like confidentiality with the mother?
SaltDeception@reddit
HIPAA requires doctors, hospitals, insurance providers, and other healthcare entities to keep your personal health information private and secure. They can’t share details about your medical conditions, treatments, or even that you’re a patient without your permission, except in specific situations like emergencies or when required by law. If someone breaks these rules and shares your health info, you can file a complaint and they could face serious penalties.
Examples:
A doctor tells your boss about your hemorrhoid problem without permission: HIPAA violation
An insurance company shares what doctors you are seeing with the news : HIPAA violation
Your mom/boss/friend posts on Facebook about your hemorrhoid problem without permission: Not a HIPAA violation (only health providers are covered)
The issue here is that the doctors on Star Trek are regularly oversharing health info. HIPAA does have an exception, though, for sharing information with military commanders when relevant to military operations, so some of it would actually be fine, but a particularly egregious example of a violation would be at the end of VOY: Pathfinder when the crew is wondering who Reg Barcley is and the Doctor shares conditions he pulled from his medical history like holo-addiction; no one needed to know that.
moktira@reddit
Thanks, appreciate the summary!
DustBunnie702@reddit (OP)
I’m glad my mom does not have a facebook. She would totally post about my hemorrhoids.
Doc_Blox@reddit
Here's my lampshade: Future HIPAA has provisions about space anomaly related medical issues, and/or Starfleet vessels' command staff are included in the group of who is allowed privileged access to medical data.
JGG5@reddit
Like I’ve posited elsewhere: every single Starfleet regulation (and likely every Federation law) has an “unless weird space shit” exception.
DustBunnie702@reddit (OP)
All the captains are so big on “not violating the Prime Directive” - until it inconveniences them or their ship.
Sufficient_Button_60@reddit
HIPAA often goes overboard. Patients certainly need some level of privacy but I have bumped into obstacles multiple times dur to HIPAA.
AceGreyroEnby@reddit
I assume that in Starfleet if there's something that could have wider implications for the starship the Dr and patient have an agreement to allow confidentiality to be put aside. That's my Watsonian interpretation, nyway.
HonkinHoots@reddit
You let it all hang in the Future, baby.
round_a_squared@reddit
The obvious answer is that HIPAA is a US law from the 21st century, and the Federation or United Earth may not have a similar law. Or if they do it may have exceptions. In this and many other cases on the show, a sudden mystery medical condition is potentially a ship security issue that the captain and senior staff need to know about.
"Your trusted senior advisor who wasn't pregnant yesterday is going to give birth tomorrow and we have no idea what caused this or what will happen next" is a pretty significant security concern.
Aridyne@reddit
Ww3, post atomic horror and at least 1 other civilization collapse
BitcoinMD@reddit
If you read the HIPAA law carefully, you’ll see that it has an exception for space
borisdidnothingwrong@reddit
AssignmentFar1038@reddit
They seem to go back and forth on it. Sometimes the doc on a trek series will refuse to discuss someone else’s medical information and other times they are very open with it. However, on a quasi military vessel, there are sometimes going to be needs to discuss someone’s medical condition, especially when their condition may affect others or is connected to a larger problem.
SaltDeception@reddit
Even in the 21st century that’s a concern. HIPAA has a built-in Military Command Exception.
AssignmentFar1038@reddit
Tru dat
HighspeedLowdrag69@reddit
Fictional characters
shibbington@reddit
HIPAA was barely a thing in the 80s when it was written. A lot of the writing for women was pretty bad in those first few seasons.
beardfearer@reddit
Join us next week to find out which alien species mind rapes Counselor Troi!
Shadoecat150@reddit
And Beverly's newest ghostly escapade. And Worf gets served for neglect
SmoreOfBabylon@reddit
You can really tell when they recycled an old Star Trek Phase II script in those early TNG seasons. As one of the guys in Red Letter Media put it “it was a show that started in the ‘80s, using scripts written in the ‘60s, by guys who grew up in the ‘30s.”
DustBunnie702@reddit (OP)
You win the Best Reddit Reply Of The Day!
Pa_Ja_Ba@reddit
Cookie_Kiki@reddit
Yoy mean Fermat's Theorem?
seek_n_hide@reddit
They ain’t civies on the streets. In space, everything wants you dead. Captain has know this type of stuff to make informed decisions about keeping folks alive. It’s not like she announced it on the ship’s intercom. Plus, Pulaski don’t take no shit, so what you gonna do about it.
cutearmy@reddit
HIPPA doesn’t apply to military. Starfleet is military
caclexis@reddit
There’s an episode of Voyager where the crew first establishes communications with StarFleet because of Reg Barclay’s efforts. The Doctor tells the entire staff, during their celebratory party, about all of his afflictions. Annoys me every time I watch it.
DustBunnie702@reddit (OP)
I just watched that episode and that’s part of what got me thinking about this question!
SpaceAdventures3D@reddit
In a show where people are often being possessed by alien forces, replaced by duplicates, being mind controlled, it makes sense that people would openly talk about strange phenomena or changes in people's behavior. Especially at a command level. It is Picard who who brings up the matter at the meeting. Troi is suddenly, and unexplainably pregnant. It don't see a problem with the Doctor and command staff discussing a miraculous, unexplainable pregnancy has occurred on ship. One could also assume of camera that Troi has confirmed with Picard that the matter is OK and necessary to discuss.
tyme@reddit
It’s worth noting that HIPAA wasn’t a law until 1996, 2 years after TNG ended.
Competitive_Toe2544@reddit
Even before HIPPA breaking doctor patient confidentiality was grounds for losing your medical license, but remember that The Enterprise is basically a military ship under military law, and the laws regarding confidentiality are bended a lot. In TOS for example there are times when Bones jnforms Kirk of a crewmembers ailment. The Captain has a right to know if a crewmembers Illness could compromise the mission.
AssignmentFar1038@reddit
It wasn’t law, but medical confidentiality was already a thing to a great extent.
BitcoinMD@reddit
In the late 21st and 22nd centuries, the increasing frequency of major data breaches, along with wearable tech broadcasting all aspects of life to social media, and the omnipresence of surveillance, led to a generational culture change where the concept of privacy no longer existed. Because of this, when the different legal systems of earth were reconciled into the Federation constitution, anything related to privacy was viewed as antiquated and even obscene, since only a barbaric and perverse human from the ancient times would have anything to hide. So HIPAA and other such laws were deliberately allowed to expire.
Shubamz@reddit
oddly they also got rid of most CCTV too
Shubamz@reddit
The only people on the ship bound by HIPAA would be really just the medical staff. and it is not now, then, nor has it ever been against HIPAA to ASK someone about someone's medical info. It only stops those bound by it from release it without approval. But anyone can ASK till they are blue in the face.
That was always the funniest part of the covid idiots when they claimed it was against HIPAA to ask them if they were vaccinated. No it isn't. It was against HIPAA for your doctor, insurance, and a few others to release that info without your approval is all. But everyone else can give it out for free if they know and anyone can still ask your doctor and insurance and waste their time, they just won't get anything from them.
There is a lot more to HIPAA beyond that too like what kind of info. for it to be protected it has to be Medical info paired with personally identifiable info. It is a pretty interesting law
AssignmentFar1038@reddit
I assumed she had already given consent for the doc to discuss it.
SportTop2610@reddit
If you're going to insert reality into television, please buy a radio.
Zapan99@reddit
They're not exactly following civilian protocols. Anything that can potentially jeopardize their mission is considered a case of force majeure, and senior officers need to be advised of the issue. There's no feelings involved when you're responsible for a space city full of children.
Ryan1869@reddit
It's common for professional athletes to sign HIPAA waivers as part of their contract, so the doctors can discuss any injury care with the team directly. It's very likely that part of being on a starship would include some kind of similar waiver for discussions among the senior officers.
SmoreOfBabylon@reddit
IIRC, Pulaski’s introduction to the series is her making a detour to Ten Forward to talk with Troi one-on-one about Troi’s pregnancy. So I’m assuming the decision was made then to bring the issue to the senior staff (since there could potentially be an unknown alien life for/potential risk on the ship).
I hate that episode, too, FWIW, just for all the other reasons.