[ Tuesday, February 10, 2004 ]


HIPAA, technology, privacy, and healthcare: Here's an interesting article in the (Ft. Worth) Star-Telegram (affectionately known locally as the Startlegram) about the migration of hospitals and other health industry participants to computer-based record keeping. I have been thinking about the dichotological breakdown of medical information, and planning on writing something about it, so I think I'll do that now.

First, let me make a few points. I don't know if it's a human characteristic or just a western one, but we are very peculiar about our privacy. Animals will do things "in front of God and everybody" that humans just won't. Animals might seek to hide themselves with camoflauge or seek private, protected areas to sleep or bear their young, but they don't do so out of a concern for privacy; they do so out of a concern for survival. It's different for humans, though, and perhaps particularly for westerners (which is not to imply that other civilizations don't have or value privacy, but just that the focus of privacy in western society is at least for purposes of this discussion a western thing, even if not exclusively). And I say all of this non-judgmentally; I'm not positing that we should want more or less privacy, just that we want privacy.

Of course, we don't want privacy in everything. In the houses we buy, the cars we drive, the clothes we wear, often we try to make ourselves noticed. Can you say American Idol (not to mention the Super Bowl halftime show)? Some people are exhibitionists more than others, but at least in some ways we all want to be noticed in a positive way.

Back to the issue of privacy, though. While we may want to drive a showy car and be the envy of our peers, we do want to keep personal things private. We especially want to keep embarassing, undignified, or "icky" things private. Interestingly enough, though, our concerns for privacy are different, depending on who the information is to be kept private from. I don't mind if my wife knows what prescription drugs I'm taking. I don't mind if my doctor knows. And I don't mind if someone I don't know who doesn't know me (and never will ) knows what drugs I'm taking. I don't want my employer or my employees to know, I don't want my neighbors to know, and I don't want my mother-in-law to know. So, my privacy concerns differ based on the identity of the potential recipient of the disclosure. That makes the issue of privacy a funny one: there are distinct classes of people where I wouldn't care if they knew (because they don't know me and never will) and distinct classes of people where I would care (my neighbors and coworkers), but some classes of people that contain those to whom I want the information provided (wife, doctor) and from whom I want the information protected (coworkers, mother-in-law).

[Sorry, had to take a break on this diatribe. I'll be back to it shortly. Stay tuned.]

Jeff [1:19 PM]

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