By Elias Aboujaoude
Account hacks. Revenge porn. Identity theft. Cyberstalking. Psychographic targeting. Facial recognition. Government surveillance. It’s enough to give up and agree with the devastatingly prescient remark from 1999 by the founder of Sun Microsystems: “You have zero privacy anyway. Get over it.” In a post-privacy world, victims of technology-enabled privacy violations look to the mental health community for guidance on how to cope and whether resignation is the answer. Yet the medical literature has been unacceptably silent on the potential negative health effects of a forced public existence, despite pre-Internet studies that establish crucial psychological functions mediated by privacy. Hippocrates must be turning in his grave. “What I may see or hear in the course of treatment … in regard to the life of men … I will keep to myself, holding such things to be shameful to be spoken about”, he once wrote, forever establishing privacy as a central bioethical tenet; one worth standing up for, defending and taking an oath on. It’s time for the medical profession to retake that privacy oath, extending it well beyond the doctor-patient relationship to support a fundamental human right to privacy as a cornerstone of well-being and psychological balance.
In this article for the Journal of Medical Ethics I argue that a “privacy bill of rights” that legally enshrines a confidential zone around individuals to protect them from existing and future technologies has become a public health priority, one that the medical community should wholeheartedly embrace. Individuals can no longer be expected, on their own, to safeguard their personal data, given the power and resource disparities between them and the entities holding that data. And technology companies have proven utterly unable or unwilling to voluntarily protect personal information, in part because of a basic conflict: collecting and commercializing data translate into cash flow. Therefore, legislative initiatives, such as the European Union’s recent General Data Protection Regulation (2018), which significantly increased organizations’ privacy protection responsibilities, and its “Right to Be Forgotten” (2014), which gave citizens basic data erasure rights, have become necessary regulatory interventions that deserve the support of the medical profession. The need to protect free speech and the public’s interest in data availability should no longer automatically outweigh people’s right to control their most personal information, for, as I try to demonstrate in the article, this approach has left us psychologically vulnerable and woefully unprepared for the ever more intrusive technologies on the horizon.
Along with the legal protections, teaching online citizenship as a preventative measure, and research into addressing the psychological consequences of privacy violations, should also be prioritized. Supporting a serious multi-pronged response to the end-of-privacy problem is the new ethical imperative for today’s doctors. It is the only hope for re-establishing the equilibrium between the individual and “Big Data”.
Paper title: Protecting Privacy to Protect Mental Health: The New Ethical Imperative
Author: Elias Aboujaoude
Affiliations: Stanford University School of Medicine
Social media accounts of post author: www.eliasaboujaoude.com
Competing interests: None declared