Can Privacy Survive In Our Brave New World?
by Stanley M. Aronson, M.D
This article was originally published on Projo.com, the Web site of The Providence Journal in Rhode Island. It is re-published with permission.
Privacy is an old word describing the condition of being withdrawn from the company of others or, alternatively, portraying a place of concealment and seclusion. These past definitions have now given way to a broader statement of meaning to define a personal form of human liberty. And there are few liberties more fervently, more deeply held by Americans — or protected more assertively — than their right of privacy.
The privilege of insulating one’s thoughts, one’s living space, one’s beliefs and apostasies, one’s integrity, one’s body, one’s very individuality represents, for many, the bedrock of fundamental freedom. And yet words such as privacy and individuality are nowhere encountered either in the Declaration of Independence or in the Preamble and first 10 Amendments of the U.S. Constitution. Synonyms such as “liberty,” “freedom of speech” and “the right of the people to be secure in their persons” abound but privacy, as the innermost sanctuary of liberty, is not expressly mentioned.
Privacy, of course, must be distinguished from secrecy. Privacy is the nourishing of one’s inner thoughts to make them worthy of guarding. Secrecy, on the other hand, is the building of a protective wall to keep outsiders from intruding, whether or not what is guarded is worth guarding.
Of man’s many possessions, his personal thoughts must have a protected sanctuary called privacy. Privacy by itself is meaningless if it doesn’t hold something to be held private; empty privacy, like an empty vault, holds nothing worth protecting. Privacy must safeguard something of substance and it then represents the culmination of a lengthy process. Before there is freedom of speech, for example, there must be freedom of thought. For unencumbered thought to be defensible it must incubate over time, like a defenseless babe, until it can uphold itself. And thinking one’s independent thoughts, some perhaps novel or nonconforming, represents hard labor since it is unaided by the comforting ideas of the majority. Even the problem with heresy requires that one has to think out, without help, one’s own unorthodoxies.
Some nations cherish the traits of privacy, individuality and nonconformity. Santayana once observed that England was a paradise of individuality, eccentricity, heresy, anomalies, hobbies and humors. And while the oft-quoted line, “For a man’s home is his castle,” was originally professed in Latin, it was nonetheless first uttered as policy in England back in 1644. Other nations, however, find privacy a deeply suspicious, alien quirk, with the cult of individuality, to be suppressed rather than sheltered.
Three ancient professions — clergy, law and medicine – each intrude upon the privacy of their constituents. But in each intrusion there is a solemn pledge to honor the secrecy of what is disclosed, whether it be in the act of confession, the discussions between a lawyer and his client or the many personal secrets that a patient will typically share with his physician.
The bond of secrecy, in medicine, harks back some 2,400 years when novitiates in the Aesclapians, the ancient guild of Greek physicians, took a solemn pledge prior to membership, a covenant now called the Hippocratic Oath. Beyond mere moral sanction, it was a binding oath upon its members. The following statement appears in this brief pledge: “And whatsoever I shall see or hear in the course of my profession, as well as outside my dealings with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets.” It bound physicians to protect the right of privacy, but it also frowned upon gossip in a non-medical context.
To this day, newly graduating physicians take this solemn oath (or some revised oath) bearing the same promise to uphold privacy. Yet some promises give way to what society calls “practicality.” In decades past, there was just the patient, the attending physician and an unstated, shared bond of secrecy. Today, there are many intruders into this partnership-of-secrecy, including clinical laboratories, imaging facilities, electrophysiological centers, countless accountants and clerical personnel — and hovering over all, are the insurance companies that pay for all of these diverse clinical resources. And thus, instead of a private compact between two, there is an Orwellian nightmare with a participating cast of thousands despite the desperate efforts of all concerned to protect the tattered remnants of patient privacy.
The forensic sciences have accelerated the drive to diminish privacy and positively identify each person’s DNA and fingerprints, innocent or not. Some have suggested that the poetry engraved on the base of the Statue of Liberty now be abbreviated to: “Give me your tired, your poor, your fingerprints.” And the future may hold only a life of increased transparency, with succeeding generations deploring their kinship with goldfish.
The diversity of views on the merit of privacy is reflected in the many, often conflicting, meanings imparted by the word “privacy.” In classical usage — as seen in cognate words such as privy and privilege — privacy meant a highborn, empowering status surviving in entities such as the Privy Council. Somewhere in the middle are newer words such as privatization. And at the lower end of the spectrum are such derivative words as privation, suggesting a divestment of something rather than an act of addition or strengthening. And in modern armies, indeed, is there any rank lower than private?
Stanley M. Aronson, M.D., a weekly contributor, is dean of medicine emeritus, at Brown University. A modified form of this column appeared in Medicine & Health/Rhode Island, the monthly publication of the Rhode Island Medical Society ( smamd@cox.net).
