However, these concerns have been hightened in recent years by new forms of data that are highly sensitive and could, if discovered and used improperly, damage an individual's psychological well-being as well as their employability and insurability. Examples of such data include the results of HIV tests and genetic susceptability testing and even the fact that testing was done without the results being known. Technological developments in the latter part of the century have created the need for a re-examination of the use of individually identifiable health data. Breakdowns in traditional safeguards for confidentiality and privacy are more easily transgressed While there are very few documented examples of such transgressions of privacy by health researchers, the potential exists, and the public's perception of a threat is very real. Thus, fundamental societal decisions are needed that balance the need for access to individually indentified health data for the public good with the equally important need of the individual for privacy.
Any access are mutually exclusive and a balanced approach is necessary.
I ncreased restrictions on access to personal health data by epidemiologists and other public health scientists could be harmful to the public good in several different ways. Routine anonymization of archived medical data has been suggested. However, such a practice would make it difficult to trace back to individuals, and because it is impossible to predict what linkages might be useful in future investigations, it is imperative that individual identifiers be retained in some manner. Another way to bolster the privacy of medical information would be to require individual informed consent for each seperate use of this information. Personal health data needs to be available on a population basis and to be free of serious selection biases, such as nonparticipation, in the population at risk, because these biases serve to undermine the scientific validity of medical and public health research.