I came across an interesting answer, would be glad to come across any other contrarion or complimentary views.
This occurs outside of blockchain as well in the context of a “break the glass” scenario https://hipaa.yale.edu/security/break-glass-procedure-granting-emergency-access-critical-ephi-systems
If blockchain is used to manage patient privacy (it doesn’t have to be used this way … it depends on the use case(s)) then how can a break the glass scenario be handled. This in turn may also depend on legal aspects, for example if I as a patient consent to my wife being able to make these kinds of decisions and record that on blockchain then does that stand up in a court of law. Can an ER doctor have special override privileges to “break the glass” if there is no family caregiver present? All such actions should of course be audited, and that can be done well on blockchain.