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Re: [Gnumed-devel] Family History tables

From: Jim Busser
Subject: Re: [Gnumed-devel] Family History tables
Date: Thu, 09 Jun 2011 00:02:59 -0700

My younger sister and I are both patients in your praxis.

You are my doctor, and my fictional sister is looked after by Dr Leonard McCoy 

My sister's last name is different from mine. In fact, it is unknown to you and 
McCoy that we are siblings. We are all living in a good size city and did not 
even know we are getting care in the same praxis. (Imagine that my sister and I 
are not friendly because I used to date her girlfriend but dumped her because 
she is crazy so now neither of them talk to me.)

Each of us are asked if there is a family history of any disorders. We each say 
that our mother developed diabetes at 52, but we did not name our mother. Does 
GNUmed wish to require a name, or does GNUmed want to have a way to enter this 
information without creating a new person "mother".

What happens if I tell you that my mother, Maria Zapato, developed diabetes at 
52? Maria could be created as a person, and the information that she developed 
diabetes at age 52 added.

Do we want to be adding health information into the file of a person based on 
what other people tell us about that person? Suppose we get a phone call from 
the local hospital that Maria is in the hospital casualty department, do we 
know her and someone looks her up in GNUmed and says "apparently, she has a 
record with us and all we have is that she got diabetes at 52".

I think that is a problem.

Suppose instead that Maria was *already* in the praxis, existing as a person 
with a history that includes diabetes and other disorders, maybe thyroid and 
diabetes and she had an abortion at 38 because she had an affair. In this 
scenario, when I tell you about my mother, you ask me my mother's name, in case 
she exists already in GNUmed, and you find her. Therefore you somehow link her 
to me as a family member, perhaps

        mother of son

and I am

        son of mother

But do we really want me, the son, to be able to know things about my mother 
that she never approved anything to be told to me?

When my sister (who hates my guts - not really) tells her doctor the same 
information about Maria, does her doctor discover (which maybe my sister and I 
did not know) that we are both in the same praxis? I would find it very strange 
after I told my doctor my mother's name and the doctor says "isn't that 
interesting? I imagine you must have a sibling named Jane Moneypenny?"

-- Jim

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