Sometimes a picture is worth, well, you know... ;-)
http://www.claybennett.com/pages/10_29_01.html
Kevin Toppenberg wrote:
This sounds like a discussion from an ethics course, where we have a
discordance between conflicting principles.
As physicians, we are trained to be patient advocates. We don't
usually step back and look at the big picture--at least those in
private practice. It takes researches in the CDC etc to address group
concerns etc. So I see this as a public health policy issue.
"Rights" can be seen as universal (the "right" to life, liberty, and
the pursuit of happiness), or perhaps granted--the "rights" of those
in China differ from our "rights". It often seems to come down to
"might is right". The government has the might, and thus dictates the
rights.
But I think that many want to do the correct/right thing for the
majority of people. Does the "right" of privacy outweigh the need for
others to be safe? I think not. Thus I would understand manditory
reporting of HIV (and especially not that it is not seen so much like
'leprosy' from the bible, and more like cancer.) But I agree with
Nancy that collecting HgbA1c's is an unreasonable breach of privacy.
But to be honest, I think that privacy is nebulus concept that is
rapidly being stripped away. We carry cell phones--> our movement can
be tracked. We watch TiVo TV--> our watching habits can be tracked.
Even our searches on Google are being tracked. I read in Wired
Magazine about thermal imaging techniques were people outside one's
home can thermally image those inside. I can anticipate times where
we all have to acknowledge that it becomes nigh unto impossible to
keep secrets.
Kevin
On 2/16/06, Ruben Safir <[EMAIL PROTECTED]> wrote:
On Thu, 2006-02-16 at 15:49 -0400, Joseph Conn wrote:
I'm with you, Nancy. The road to Hell is paved with good intentions and
I'm surprised I haven't heard the ACLU filing an injunction against NYC
on this program. Since diabetes is not contagious, I don't think that
because the city may end up paying the cost of care for some of its
citizens gives it the right to snoop on all of its citizens.
What is this? Your making a bald faced lie here. You know as well as
anyone on this list that the costs here is not just a few dollars, but
money that runs into the BILLIONS not to mention the real morbitiy and
mortality.
But what do you care? Your not a minority poor from Brownsville, or a
tax payer of the city of New York so its no sweat off your back.
Disguesting....
This
program isn't a slippery slope in my book, it's a toboggan run.
Joseph Conn
Staff writer
Modern Healthcare
Modern Physician
Heatlh IT Strategist
312-649-5395
[EMAIL PROTECTED]
Check out the NEW ModernPhysician.com, and register now for Modern
Physician Stat and Modern Physician Alert
[EMAIL PROTECTED] 2/16/2006 1:27 PM >>>
Most if not all health departments require that contacts be notified.
They
just don't allow the contact to be told who had the positive HIV test
without
permission.
I don't think anyone who has a positive HIV test is a priori a
murderer.
If someone in NYC hears the Health Department is collecting this data
and does
not want a Health Department envelope arriving in his mailbox, he has
no way
to stop that at the moment. He cannot contact the Health Department
until
they contact him by mail. If he wishes to keep the fact he has
diabetes to
himself, that makes it very difficult if someone else uses the same
mailbox.
And collecting every A1C that has been done does not even invade the
privacy
of just the diabetics. I am sure it is much easier just to grab all of
the
data than it is to write the programs to sort out all the A1Cs above 7,
so
they took the easy out. This represents a little more sliding down
that
slippery slope and the program is just getting started!
On Thursday 16 February 2006 13:29, Ruben Safir wrote:
On Thu, 2006-02-16 at 12:07, Nancy Anthracite wrote:
I have been working with the CDC with an eye to include in VistA the
option
to report deidentified data to the Biosense project to help with the
early
detection of disease such outbreaks, etc. Privacy does not have to
be
violated in order to achieve most of what you are concerned about.
Yeah, actually it does.
In order to intervene with specific patient about their diabetes, the
individual patient must be contacted. In order to prevent potential
sex
partners from getting AIDs and dieing, the diseased patients identity,
and their current and recent sex partners need to be identified AND
contacts.
in the later case you have to decide if your for or against murder.
Ruben
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