Is a Philippines middle name a name like any other?

[jgsuess]

Philippines middle names tell you something about the person's lineage. Is that important enough to model them explicitly?

[gpfvillanueva]

In our setting, there are times where we use the middle name to confirm if we are talking about the same patient aside from Birthdate.

[jgsuess]

Will the general given name field work for this?
Does the presence have to be enforced?
Datatypes-definitions - FHIR v4.0.1 https://hl7.org/fhir/R4/datatypes-definitions.html#HumanName.given

[niccoreyes]

I think discriminating between Middle Name = Mother's Maiden Name has to be explicitly mentioned.

For example: Name = Juan Carlo Dela Cruz Fernando (Juan Carlo D. Fernando)
can be broken down into 3 chunks: "Juan Carlo", "Dela Cruz", "Fernando"

• Given name:
• First name [Juan]
• Second Name [Carlo]
• Middle name/Mother's Maiden Name: Dela Cruz (often just abbreviated as a single letter for example in this case. D.)
• Family Name: Fernando

When I was younger, I thought that my middle name would probably be my second name. I wouldn't be surprised if people captured their second name as the middle name for many forms and placeholders.

Eventually I learned that in our Civil Code:

Articles 364-375 of the Civil Code fix the default rule: a legitimate or legitimated child “shall principally use the surname of the father,” while the mother’s maiden surname functions as the middle name. Married women may adopt their husband’s surname in several styles (Art. 370). Importantly, “no person can change his name…without judicial authority” (Art. 376).

So having a consensus on where to put the middle name is important. Whether as an extension, or an agreed use for the second index of the given[].

[lesterbatayan]

Philippines middle names tell you something about the person's lineage. Is that important enough to model them explicitly?

I think it should be modeled explicitly.

In the PH setting, middle names are used differently.
For PH, Middle name = mother's maiden name. It is used in many official transactions.
In other countries, middle names are optional.

[niccoreyes]

Yes I agree, the Civil Code also mentions that the mother’s maiden surname functions as the middle name in most situations. However there are indeed edge cases, which is probably covered in the Civil Code as well, or the absence of it.

[gpfvillanueva]

Can you provide an official transaction sir where we use Middle name and Maiden Name (based on your experience) this will also help us if "Maiden Name" should also be included in PH Core. @lesterbatayan

[lesterbatayan]

Sorry I think i did not word that properly.
When I say middle name, I mean my mother's maiden surname. I did not mean to imply that they are separate, because in our context they are the same thing.

[niccoreyes]

I have previously made a discussion on Zulip for a different concern. I belive it was Mother's Maiden Name

in particular, I have documented the policies related to enforce the use of middle names as per law and policy
> Discussion on Representation of Middle Name and Maiden Name @ 💬

This article kind of consolidates the context of the laws & policies of concern Name Format Discrepancies in Official Documents in the Philippines
See section on:

1. Statutory structure
   Articles 364-375 of the Civil Code fix the default rule: a legitimate or legitimated child “shall principally use the surname of the father,” while the mother’s maiden surname functions as the middle name. Married women may adopt their husband’s surname in several styles (Art. 370). Importantly, “no person can change his name…without judicial authority” (Art. 376). (Lawphil)

2. Cultural practice
   In everyday use, the three-component format—Given Name + Mother’s Maiden (Middle) + Father’s Surname—is near-universal, so computers, legal forms, and databases assume that order. Suffixes (“Jr.,” “II”), honorific abbreviations (“Ma.” for Maria, “Fr.” for Francisco), and dual given names (e.g., “Juan Paolo”) complicate data capture. When any element is dropped or re-ordered, downstream documents fail validation, triggering red flags in KYC, AML, and immigration systems.

Having an Explicit method to capture Middle name should be present. Not necessarily slicing as I previously mentioned.

[jgsuess]

That was exactly the argument that John Carter made after investigating this for a while. I let the discussion here go the way it wanted to make sure this is objective. But just saying, John had the same conclusion. In the Philippines we actually need an extension it seems.

[niccoreyes]

yes, agree, I remember this was the recommendation by John Carter as well

[jgsuess]

Maybe this is the right time to write an issue. We even have some legal background for the documentation and practical examples.

[jgsuess]

We can make up a case where this is a problem and leads to an incorrect identification.

[niccoreyes]

I think this discussion could be concluded for now as we agreed so far to consume what HL7 FHIR offers out of the box. There are too many edge cases in the PH, and the base FHIR name strategies covers this.

The latest version of PH Core captures this in a narrative form to encode the first name in given[0] and given[1] accordingly