You are Being Watched: Privacy in the United

Transcript:You are Being Watched: Privacy in the United:
You are Being Watched: Privacy in the United States Martin Donohoe http://www.publichealthandsocialjustice.org http://www.phsj.org martindonohoe@phsj.org Outline History of privacy in the US Health Care Corporate espionage Drug testing Other erosions of privacy Whistleblowers Safeguarding privacy History of Privacy Protections in the U.S. 1st Amendment – right of belief 3rd Amendment – right to privacy within home 4th Amendment – protection against unreasonable search and seizure 14th Amendment – prohibition against deprivation of life, liberty, or property without due process; equal protection under the laws History of Privacy Protections in the U.S. 1890 – Justices Brandeis and Warren – “the right to be let alone” 1965 – SCOTUS - right of married persons to obtain contraceptives 1967 – SCOTUS - overturns ban on interracial marriage 1972 – SCOTUS – right of unmarried persons to obtain contraceptives 1973 – SCOTUS – Rowe v. Wade – limited right to abortion (further delineated by SCOTUS in Planned Parenthood v. Casey, 1992) Anti-Discrimination Protections Federal Civil Rights Act of 1964: outlaws discrimination based on race, color, religion, sex, or national origin Title IX: Bans discrimination based on sex in federally-funded education programs (including sports) Privacy Protections Various federal and state laws re privacy, confidentiality, security, use, and disclosure of public health information 2017: Trump overturns internet privacy protections created by FCC under Obama Allows internet service providers to track and sell customers’ online information with greater ease UN Declaration of Human Rights: “No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence, nor to attacks on his honor or reputation” Privacy in Clinical Medicine Open Notes (5 million charts) Patients recording visits Utility: May improve patients’ understanding of condition, risks/benefits of treatment, compliance Useful for memory-impaired or illiterate patients, those with caregivers, those “shocked” by new diagnosis Not prohibited by HIPAA May increase litigation, inhibit or stilt conversation, increase defensive medicine, undermine privacy of others if marriage or family history included Privacy in Clinical Medicine Alternatives: Record beginning and end of visit Readable patient summaries Interdisciplinary visits Follow-up phone calls/visits Presence of patient advocates Privacy in Clinical Medicine Mystery/Simulated Patients 40 companies nationwide (e.g., Healthcare Impression Management Services, Perception Strategies, etc.); some institutions hire mystery patients directly, others utilize employees Phone calls/actual visits to assess practice environment, physician communication, and medical decision-making Employed by clinics and used by researchers and activists (e.g., insurance status and appointment waiting time, provision of emergency