As America's gun violence epidemic continues, many people are wondering how so many troubled and dangerous individuals escaped relevant authorities' notice for so long. Surely someone unstable enough to commit such heinous acts would display warning signs, right? Yes, it turns out the people most equipped to pick up on these signs often do. But there's a problem: the professionals who are often able to make note of an individual's tendency towards violence are their doctors — the same doctors who are legally required to keep such information confidential.
The Health Insurance Portability and Accountability Act, or HIPAA, is an important piece of legislation that keeps interactions between doctors and their patients private. It also outlaws employer discrimination based on medical history, which is definitely up there on the list of "super important laws to have in a fair society." But because of doctor/patient confidentiality, physicians are not allowed to report someone as a potential risk unless they pose a threat that is both “serious” and “imminent.”
According to David Rosmarin, Director of Forensic Psychiatry at Harvard Medical School’s McLean Hospital:
Sometimes the only person who is aware that there’s a serious and imminent threat is a physician, and that clinician is barred under HIPAA from disclosing that threat if it’s below serious and imminent.