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Opening Arguments

What's up, Doc?

In the digital age, medical people can share information about us more easily, but our medical privacy is harder to maintain:

The letter crafted by the federal advisory panel, sent Feb. 20 to U.S. Health and Human Services Secretary Mike Leavitt, noted that computerized health records hold great potential for improving the effectiveness and efficiency of health care. But the letter also noted that such records also mean that every doctor, nurse, pharmacist, chiropractor and dentist, and other health-care workers, have potential access to a patient's complete medical history.

The panel also recommended that health-care workers be able to "break the glass" and access private information if needed in an emergency.

Such measures are needed in a highly connected world, said Mark Rothstein, a member of the committee, which spent about 15 months crafting the recommendations letter.

"People are suddenly going to find there's no way to compartmentalize the sensitive things in their health histories from the nonsensitive things in their health histories," said Rothstein, a lawyer who also is director of the Institute for Bioethics, Health Policy and Law at the University of Louisville School of Medicine.

"Someone who is treating you for a broken leg doesn't need to know you had an abortion 20 years ago."

Rothstein said another worry he has about highly detailed electronic patient histories is the prospect of patients being rejected by employers or insurance companies because now-scattered details of their health histories would be more easily available.

I don't think there's one answer -- it depends on your circumstances. When I was younger and convinced of my own invincibility, I would have been more worried about privacy and controlling who knew what about me. Now that I'm older and more worried about health care than the next job interview, I want a physician diagnosing me to know everything she can possibly know about my medical history, whether I think it's important or not. But as those once-scattered details are gathered together, the information also becomes more available to those outside the medical profession I might not want to see it. Considering our eroding sense of privacy these days, I suspect this will be a continuing challenge.