Chapter 7: Tracking Employees by Cell: The Biological Version

Overview

For more than 2,400 years, the relationship between physician and patient has been buttressed by a principle of strict confidentiality. In 400 B.C., the Greek physician Hippocrates developed an Oath of Medical Ethics, and among the tenets he crafted was the following:

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about. ^[1]

In 1847, when the American Medical Association was founded, the new organization chose not to adopt the Hippocratic Oath. Instead, the AMA endorsed a Code of Medical Ethics, which contained a similar but slightly less explicit secrecy provision:

2.... Secrecy and delicacy ... should be strictly observed; and the familiar and confidential intercourse to which physicians are admitted in their professional visits, should be used with discretion. ... The obligation of secrecy extends beyond the period of professional services;—none of the privacies of personal and domestic life, no infirmity of disposition or flaw of character observed during professional attendance, should ever be divulged by him except when he is imperatively required to do so.

The vast majority of medical professionals take the concept of confidentiality very seriously. They recognize that their ability to treat their patients depends on the patients' openness with them and their trust that potentially embarrassing information will be kept private. Few people would put up with the rigors of medical school and residency without a genuine desire to help people, and patient confidentiality is an important tool in being able to properly diagnose and treat the sick.

However, as we'll see in the first part of this chapter, health care costs are one of the most challenging issues facing the nation's employers. At the same time, various technological innovations, ranging from more sensitive drug tests to DNA testing, are making it easier to assess both the current fitness and future health of employees. Taken together, these trends make it all too compelling for insurance companies and employers to peer over a doctor's shoulder as she is examining her patients.

^[1]Translation from the Greek by Ludwig Edelstein From The Hippocratic Oath: Text, Translation, and Interpretation, by Ludwig Edelstein (Baltimore: Johns Hopkins Press, 1943).