Privacy and Medicine: A Comment The Regulation of Managed Care Organizations and the Doctor-Patient

Cass R. Sunstein


One of the characteristics of a free society should be a strong presumption in favor of full patient control over personal information. The presumption is rebutted when disclosure to others is necessary (1) for good patient care, as in the case of consultations and medical teams; (2) to compile information that will produce scientific or medical progress; (3) to protect third parties from serious risks of harm; and (4) to prevent harm to patients themselves. In all of these cases, identifying information should be removed unless it is necessary. Principles of this sort should be implemented via physician norms, in fact publicly acknowledged physician norms, and (only) if necessary, by more formal regulations, private and public.