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Health Care Information and the Protection of Personal Privacy: Ethical and Legal Considerations

Lawrence Gostin, JD
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From the Georgetown University/Johns Hopkins University Program on Law and Public Health, Washington, D.C. Note: This article is one of a series of articles comprising an Annals of Internal Medicine supplement entitled “Measuring Quality, Outcomes, and Cost of Care Using Large Databases: The Sixth Regenstrief Conference.” To see a complete list of the articles included in this supplement, please view its Table of Contents. Note: The author chaired the public health information privacy project supported by the Centers for Disease Control and Prevention, the Council of State and Territorial Epidemiologists, and the Carter Presidential Center. Copies of the full report are available from the National AIDS Information Clearinghouse (1-800-458-5231): Gostin LO, Lazzarini, L. Legislative Survey of State Confidentiality Laws. Atlanta, GA: Centers for Disease Control and Prevention, 1996 (Order No. D914). The views expressed in this article are those of the author and do not necessarily reflect the official policy of the U.S. Department of Health and Human Services, the Council of State and Territorial Epidemiologists, or the Carter Presidential Center. Acknowledgments: The author thanks Willis Forrester, John Ward, James Buehler, Zita Lazzarini, and Kathleen Flaherty. Requests for Reprints: Lawrence Gostin, JD, Georgetown University/Johns Hopkins University, Program on Law and Public Health, 600 New Jersey Avenue, NW, Washington, DC 20001-2079.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1997;127(8_Part_2):683-690. doi:10.7326/0003-4819-127-8_Part_2-199710151-00050
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During the early 1990s, the U.S. government addressed the issue of providing universal health care to all its citizens. Although this issue has not been completely resolved, centralization of electronic data and sharing of health care information among insurers and providers have been pursued. The emergence of electronic data banks in health care has raised another issue: each citizen's right to privacy compared with the collective benefit to society when critical data on quality assurance and scientific research are shared by an array of network users. The choices we face are difficult, and the solution may necessarily reflect a compromise that alters traditional beliefs in the right to personal privacy. However, Congress can take the initiative by enacting statutes to ensure that sensitive information contained in electronic patient records is not divulged without a patient's consent and is protected against fraudulent access and abuse.


ethics ; privacy





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