This really disturbs me. After all, we are not talking about preventing the spread of a communicable disease. Where is the compelling public interest in giving mere government employees access to the medical records of citizens without their consent, absent a threat of passing the disease on to other citizens?

On Jan. 15, New York City began requiring local clinical laboratories to report to the city health department the results of blood sugar tests performed on citizens. The department plans to use the information to improve surveillance for diabetes, which afflicts an estimated one out of eight New Yorkers and to "target interventions." Specifically, if you live in New York and have trouble resisting sweets, your doctor may soon receive a call from the health department suggesting that he or she needs to persuade you to change your lifestyle.

What makes this development so extraordinary in the annals of American public health is that diabetes is not a disease you can catch from, or give to, anyone else. U.S. governments have a long history of imposing quarantines and otherwise restricting the liberties of people suspected of carrying contagious disease. Early in the last century, for example, the very same New York City health department famously exiled Mary Mallon (aka "Typhoid Mary"), along with many other infectious patients, to a tiny island "colony" in the East River
Policies that require the reporting of sexually transmitted diseases to public health authorities similarly derive justification from the threat of contagion. Even recently enacted smoking bans in New York and elsewhere were passed only after the public accepted findings that secondhand smoke poses a serious health threat to others.

But diabetes, though now a fearsome epidemic, is not communicable; nor do the behaviors that lead to the disease (primarily lack of exercise and improper diet) put others at risk of illness. It cannot even be said of diabetics, as is often said of illegal drug users, that their habits foster a life of crime or fund crime syndicates and terrorist networks. So how does it become a matter of public interest that governments monitor the medical records of individual citizens for telltale signs of high blood sugar -- much less that they "target interventions"? Isn't this the ultimate example of the nanny state run amok?

Yes, it is – and all the attempts to justify this intrusion into the medical privacy of individual citizens based upon the need for research data, coordination of medical care, and cost effectiveness fall flat when faced with the simple fact that this goes against the fundamental right to be secure in one’s person and one’s papers and effects. Absent a serious threat to the health of others, there is no legitimate basis for this power grab.

Posted by: Greg at 11:56 AM | No Comments | Add Comment
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