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Privacy Rights Alert

    From:  American Civil Liberties Union of Massachusetts
           [email protected]
    Re:    Privacy Rights Alert
    Date: November 20, 1995
    c 1995 ACLUMA
         We at the American Civil Liberties Union of Massachusetts want to
alert you to the fact that the right to medical privacy of all Americans is
imperiled by a bill just introduced in the U.S. Congress.  This bill, which
is claimed to be a  "Medical Records Confidentiality Act,"  in reality may
turn out to be profoundly destructive of your right to privacy. 
         Although Part I does contain certain aspects which     could help
privacy, Part II undercuts the very fabric of patient- doctor
         First, it preempts many state law and common law  protections which
currently exist.  
         Second, it pushes the further computerization of medical records,
and will bring about the creation of "Health Information Services"  ---
corporate entities which would receive, process, and serve as libraries for
actual on-line medical records forwarded from hospitals, clinics, and
individual doctors.  It appears that this will take place without any
requirement for individual patients' authorization or consent.
         As we all know, computerized data bases are not immune     from
being accessed by both unauthorized  "outsiders"  and   unauthorized
"insiders."   Centralization of data storage,   especially in electronic
form, simplifies its being accessed.
         But aside from that, the bill would actually authorize
access to the medical records in these data bases by a host     of government
and non-government entities.  Each of our medical records would thus become
part of a computerized "lending library"  --- an internet of medical records.
         For example, the bill would permit release of your medical records
from "Health Information Services" (the on-line data base holders) and
"Health Information 'Trustees'" (providers, hospitals, health plans,
employers, insurers, and health oversight agencies) to the following (among
              - Release to researchers (along with your medical
history, it is possible that identifying
                information including your name, address, and 
                phone number would be sent).
              - Nearly-automatic release, to the opposing party 
                in a lawsuit, of your entire medical history, if
                your health, physical or mental, has been raised 
                by you as an issue in that lawsuit.
              - Release to law-enforcement authorities under
certain circumstances.
              - Release to Public Health Agencies under certain
              - Release based on Judicial Warrant --- you would
be notified by mail within 30 days after                         execution of
the warrant (90 days or more with 
                the government's ex parte option).
              - Release based on Judicial Subpoena, Grand Jury
Subpoena, or Administrative Agency (e.g. Social                  Security)
Subpoena --- you would be notified on        or before the date of its
execution (or within
                90 days thereafter [or longer] with the
government's ex parte option).
                          -A special variant of this, where the
identity of the patient is "unknown," would                      allow the
search of records (plural) in           order to identify the person being
sought.        [In essence, this would allow "fishing"   expeditions, using a
computerized net, into
                      the private lives of Americans.]

         In some of these situations, you, the patient, will
only be informed after the records have been released.
         You may, in some circumstances, have the legal right to
"attempt to quash" the subpoena (etc.) by seeking a court's
intervention.  However, the standard by which the court is
to reach a decision on this will be mandated by this bill to
be a consideration of whether the government's interest in obtaining the
information outweighs the privacy interest of the individual.
         We would encourage you to pull up a copy of the actual
bill and view it yourself.  This can be done through the
Library of Congress internet site at http:\\thomas.loc.gov
(104th Congress,  Senate bill number  S 1360 ).
         Alternatively, a hard copy by mail can be requested
from the U.S. Senate Documents Room, by faxing to 202-228-2815 
a note containing the bill number and your mailing address.
         All our voices need to be heard in order to help make
certain that this bill is not passed by Congress.  
         Possible actions include: (1) Letters to your Senators and
congresspersons, and to the House and Senate leadership.
(2) Letters to local newspapers and other media.  (3) Forwarding the contents
of this message to places where you feel it will be
of interest and have impact.
         This document may be re-distributed freely, provided it remains in
its entirety.
         If you value your right to privacy, the time to act is now....