NYC wants to track diabetics
posted by:Marty // 11:49 AM // August 14, 2005 // Surveillance and social sorting
New York City recently proposed a new plan to track diabetic New Yorkers. The plan would call for area medical labs to report the results of a diabetes test that can indicate the effectiveness of a person's care. The program would flag patients whose care is lapsing and send notes to their doctors. It is then up to the doctor to follow through and contact the patient.
This article from the Associated Press, via the Seattle Times, provides us with soundbytes from two sides of this issue....
In this corner, we have the City of New York:
There will be some people who will say, 'What business of the government is it to know that my diabetes is not in control?' " said Dr. Thomas Frieden, the city's health commissioner.
The answer, he said, is that diabetes costs an estimated $5 billion a year to treat in New York and was the fourth leading cause of death in the city in 2003, killing 1,891 people.
By pinpointing problem patients, then intervening in their care, Frieden said the city can improve thousands of lives. "I don't think we can afford not to do anything," he said.
And in this corner, we have those with privacy interests in mind:
This isn't smallpox," said James Pyles, an attorney who represents health-care groups concerned with medical privacy. "The state, or the city in this case, does not have a compelling interest in the health of an individual that overrides that individual's right to privacy."
And in this third corner, we have the medical community:
Dr. Nathaniel Clark, vice president for clinical affairs of the American Diabetes Association, said the surveillance system could be a great tool for doctors who find it difficult to track patients over long periods. Currently, he said, people who aren't aggressive about their care can easily fall through the cracks. Some switch health-care providers, and many people living in poor neighborhoods where diabetes is common don't have a regular doctor.
Given the recent trend of security breaches, can such a database really be trusted? Does the end-goal truly justify such a program? Was this proposal drawn up based on a business case or on actual healthcare goals? Should government tracking be limited only to infectious diseases, or just to other major health epidemics? Or should all tracking be ruled out? Given that this program is not seeking healthcare data in the aggregate, but to target individual people, does the stepping on one’s privacy balance against the personal health handholding/looking out for you by the government?
What, I believe, is most compelling here is the issue of consent. Initially, at least, all patients will be flagged for the system. Only afterwards will they be able to opt-out. Think of the above questions, again, in light of a opt-out mechanism, do any of your opinions change? Is this a case of Government Knows Best?
http://seattletimes.nwsource.com/html/health/2002402162_diabetes26.html
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