I'm honestly not trying to argue with you. Using examples like him having soiled himself as a reason why you should become his guardian is, at best, emotional manipulation and points to nothing that validly should give you the right to make his decisions. I am not saying it's a good thing to not clean yourself, but I am saying that taking a person's rights away should sincerely be the absolute LAST thing anyone should do or allow another person to do.

As far as the privacy laws, they are actually in place specifically because people (however related) feel they have some entitlement to private information about someone else. The fact is that you don't have the "right" to this information. It seems to me, whenever he originally started seeing his therapist he would have given HIPPA consent if he wanted you to have it. And, as you have not indicated whether he's still in the midst of a psychotic episode, I would assume that he's choosing now to not allow you to have access to his private information. Spouse and trust and all that are great, but everyone, regardless of how they are related to whomever deserves to have privacy and deserves to make their own medical decisions.