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Article Title

Scientific Thinking - Religious Practice - Medical Confidentiality - Technology: On A Collision Course?

In the world of science, the generally accepted view of "scientific thinking” involves the element of being able to objectively reproduce experimentation and collect related, valid data to either support or refute claims. It would then follow that in order to allow for this, "thinking” has to be shared and ideas / methods made available. Traditionally, for example, Laboratory A (Institution A; or Individual A) developed / researched a product or process or idea that is initially maintained in secrecy or protective cover, and then decided with whom to share this information, often for the purpose of validation, possibly for the purpose of publication. What was being researched would be of benefit to many. In other words, altruistically the overriding principles in the world of science are the search for truth and the "concern for the greater population”. This, then, would call for the constant sharing of information. However laboratories and research institutions are frequently in competition with each other and for money. Although unfortunately, and too frequently, personal greed, or the concern for a "selected population,” becomes the principle goal.

Historically (especially during the 1400s – 1600s) religion had a pretty good grip on what information should be disseminated and what information should be protected. This behavior is seen at some level in all religions. The fundamental goal is to protect and/ or to save the followers of the particular belief. This overseeing of information was not restricted to individual personal information, or "affairs of state.” Although religion obviously had a difficult time attempting to maintain a ban on Galileo’s scientific thinking involving the earth’s rotation around the sun. In the world of science when Anton Van Leeuwenhoek tried to tell people that "animalcules” existed, albeit so small that they could not be seen with the naked eye, he was shut down. Of course there is the ongoing debate between evolution and creationism. Not just the basic ideologies, but whether or not any information about "the other” should even be disseminated.

In medicine, the blending of confidentiality and privacy has always been a strong yet sensitive element, helping to establish the bond in the clinician-patient relationship. Quite often this bond is what supports compliance in a patient. This does require decisions to be made with regard to which information might be divulged, and to whom, and under what circumstances.

We already see this spirit of confidentiality being redefined in three different venues: the clinician – patient relationship; the attorney – client relationship; and within the military. Today medicine is adapting to the new age of technology. Information regarding the patient is being "computerized, digitalized, datarized, categorized, and centralized.” Not only the direct clinician-patient contact information (that which is exchanged within the clinician’s office), but indirect related information as well; for example, the billions of prescriptions that were written by clinicians and then filled by the pharmacists. That information winds up in detailed listings somewhere in cyber space. When we think of the patient visiting the clinician, we envision the patient talking to his/her clinician in privacy and the clinician listening and possibly making some notes. Those notes went into a file folder which was then inserted on a shelf or in a cabinet. So what the patient said was now written in some shorthand/code scratches or locked up in the hippocampus of the clinician. If the patient went to another clinician, he/she either carried a copy of the clinician’s notes, or with consent the clinician mailed notes or phones the other clinician personally. What is on the horizon is the patient enters the office and either immediately or eventually the clinician’s notes are entered into a data base, either local or central (somewhere). The upside is less space is taken up (probably some money saved in the management of the office)…however the downside is that the information is now potentially more exposed.

We see increasingly more sophisticated technology extending our senses such as the ability to hear more, see more, record more, decode / decipher more, virtually without restrictions. Just walking to the grocery store may be exposing oneself to being recorded visually and/or audibly. When sitting in a den, watching TV one may be vulnerable to visual, audio, or behavioral surveillance via activity monitoring through the TV, radio, or phone, technology. Add to this the concerns developing over the constantly expanding "current use and future potential use” that exists with the increasing pace of our discovering the control of, and the abuse of, cyber space. The point is we are just about in to, or near approaching, the time when we should / will have to rethink such concepts as privacy and confidentiality. The legalities, ethics, priorities, and influence on relationships, and on information gathering, storing, sharing, and exposing. Should we be re-thinking what we mean by "privacy” and/or "confidentiality”?

How will the worlds of science, medicine, academia, and religion come to agreement in dealing with the information being exposed in the unraveling and eventual potential control of the genetic makeup? Traditionally confidentiality in medicine has been virtually untouchable.

Between the constant, newly developing, microscopic and technologic advances in genetics and DNA engineering, and evolving capacity for data storing and transferring, are scientific thinking, religious practice, technological advancement, and medical confidentiality heading on a collision course?

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