BMJ - PKI and signinng slight confusion

Thu, 14 Sep 2000 14:44:53 +0200

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In the Netherlands the situatio is that the provider owns the medium and the
patient all that what is recorded.
Ultimately the patient has all controls.
One restriction is the situation when revealing the whole record compromises
privacy of others.
An other restriction is when revealing information might harm the patient.

My private opinion is that authorship of the provider makes it so that he is
co-owner of the information. The reason is because what is recorded by the
provider is his personal view. All relevant context's are recorded in the
goal. In real life we know that only some of the context's are recorded. It
is therefor that when others (patients included) whan information from the
record only the provider knows to soem extent which non-recorded context's
are relevant.
A second reason is that patients don't know how to interpret the information
and don't know the consequences of obtaining information. Once information
is revealed to them they will have to anser questions faithfully that are
asked by organsisations (insurers,..).
Patient need a proxy that help them ddivulge information in the record.
Ultimately patients will have the right to do as many stupid things as they
like. I don't think that patients when asking for a service as completely
free persons and that is why I think a proxy is necessary.

Gerard

|-----Original Message-----
|From: owner-ukcrypto@maillist.ox.ac.uk
|[mailto:owner-ukcrypto@maillist.ox.ac.uk]On Behalf Of
|M.Wells@leeds.ac.uk
|Sent: donderdag 14 september 2000 12:01
|To: ukcrypto@maillist.ox.ac.uk
|Subject: BMJ - PKI and signinng slight confusion
|
|
|Brian Gladman wrote:
|
|
|>
|>
|> > At 10:54 pm +0100 12/9/00, Adrian Midgley wrote:
|> > >...I don't buy the paper I use.  It arrives in boxes form the HA
|> > ...
|> > It doesn't seem obvious to me that whoever owns a sheet of paper
|> > necessarily owns whatever gets written on it, but separate ownership
|> > of a sheet of paper and something that is written on it is also an
|> > interesting concept. I hope some legally trained folk will help us
|> > out here...
|>
|> I agree.  It is surely clear from the law suits going on about music
|> distribution that intellectual rights exist at a more abstract level than
|> the physical media involved.
|>
|> It is also interesting to see a possible tussle developing
|between medical
|> professionals and their clients on which group might 'own'
|medical records
|> and medical information.  Its not obvious to me that this is
|easy to resolve
|> unless the two groups have come to an agreement covering the
|basis on which
|> the service in question is being provided.
|>
|> However, it is probably more important to worry about management
|and control
|> rather than ownership per se.
|>
|>     Brian
|
|I have often found it helpful to think of the 'owner' of an item of data
|as being the person who can cause its value to alter.  Data items
|come in (at least) two flavours;  those which follow the value of
|something in the real world, and those which define the value of
|something in the real worls.
|
|When we think of a Patient's records, all sorts of things in there are
|clearly capable of being altered by the Patient him/herself (I have in
|mind things like home address, dietary habits, and whether or not
|the Patient actually takes any medication that is prescribed);
|these are examples of my first group, the data items which follow
|the real world.  Some things are altered by the Medical Practitioner
|(what medication or treatment is prescribed/recommended);  these
|are examples of my second group, where the real world
|supposedly behaves as the Practitioner decides.
|
|However, some items are just handed to us on a plate (blood
|pressure, presence of a specific infectious agent ) and we simply
|have to take it as being controlled by neither the Patient nor the
|Practitioner.
|
|Like anyhting else in this area, the approach breaks down if you
|push it too hard, but it can be a helpful way of looking at some
|issues.
|
|Mike Wells
|
|
|
|
|

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