Retten til privathed i det danske sundhedsvæsen

Formalet med naervaerende oversigtsartikel er at undersoge den stigende digitalisering og deling af personlige informationer i sundhedsvaesenet, samt hvilke etiske udfordringer denne udvikling har for den enkelte borger. Mere praecis vil vi rammesaette denne diskussion i en dansk kontekst eksemplificeret ved Det Faelles Medicinkort. Det Faelles Medicinkort er en obligatorisk database for danske borgere indeholdende informationer om patienters medicinske historie to ar tilbage. Denne database kan tilgas af en bred vifte af sundhedsprofessionelle i Danmark (Bekendtgorelse om Laegemiddelstyrelsens elektroniske registrering af de enkelte borgeres medicinoplysninger 2011). Pa trods af lovede sundhedsmaessige fordele, sasom en hojere grad af sikkerhed i forbindelse med medicinering, en oget effektivisering af sundhedsvaesenet og dermed besparelser pa de offentlige budgetter, plaederer vi i artiklen for, at implementeringen af Det Faelles Medicinkort kompromitterer den enkeltes privathed. Den enkelte borger er ikke i tilstraekkelig grad informeret om brugen af Det Faelles Medicinkort. Ydermere finder vi ikke, at borgerens autonomi i forhold til indholdet af personlige oplysninger i Det Faelles Medicinkort er opretholdt pa en tilfredsstillende made. Artiklens primaere perspektiv er deontologisk, men for at nuancere vores diskussion inddrages lejlighedsvist ogsa utilitaristiske argumenter. Endvidere inddrages i artiklen Helen Nissenbaum, Tom L. Beauchamp og James F. Childress samt John Rawls. I artiklen vil tre konkrete problemstillinger blive diskuteret i relation til Det Faelles Medicinkort: (1) Deler vi relevante og passende data? (2) Er distributionen af disse data til en sa bred vifte af sundhedsprofessionelle pa sin plads? Og slutteligt: (3) Er den enkelte borgers beslutningsdygtighed, og dermed mulighed for autonomi i forhold til personrelaterede informationer, tilstraekkelig. Nogleord : digitalisering, privathed, Danmark, sundhedsvaesen, Det Faelles Medicinkort English summary: The right to privacy in Danish healthcare The scope of this paper is to assess the growing digitalization of personal information in healthcare and the ethical challenges this development poses to the citizen. Specifically the paper discusses the right to privacy in a Danish context, namely in relation to the use of The Shared Medical Record. The Shared Medical Record is a default digital health record consisting of every patient’s medical history for the previous two years, accessible to a broad range of health professionals in Denmark. In this paper we discuss three aspects of The Shared Medical Record, primarily from a normative point of view: 1) Are the personal data shared by The Shared Medical Record relevant and appropriate? 2) Is the distribution of this information to the current array of health professionals appropriate? And 3) Does The Shared Medical Record adequately support and account for the quorum and autonomy of the individual citizen with regards to personal information? We argue that, advantages such as heightened security, efficiency and convenience aside, the citizens’ right to privacy is to some extent compromised by the terms and use of this record. The citizen is not extensively informed on the use of the record, and does not hold a sufficient degree of autonomy over the content and distribution of their personal data. The primary ethical perspective of the paper is deontological, but in order to properly nuance our stance we have chosen to include traditionally utilitarian points of view throughout our discussions. In the paper we introduce Helen Nissenbaum’s notion of contextual integrity in order to thoroughly assess the service’s ethical implications for Danish citizens and their future privacy, as well as points from John Rawls, Tom L. Beauchamp and James F. Childress.