Rule 1005 There is no privilege under this article in a proceeding brought by or on behalf of the patient to establish his competence.

If a patient goes to court to prove they are mentally or physically competent, their medical records and information can be used as evidence. The normal protections that keep medical information private do not apply in this situation.

This makes sense because the patient is the one asking the court to look at their health. Since they brought up their own competence, they cannot block medical information from being shared in that same case.