Monday, June 21, 2010
Invasion of Privacy: Sexual Orientation Edition
Today I scheduled an appointment with a GP for my yearly checkup. I'm not physically sick or injured at the moment, but I figured it would be worthwhile setting up an appointment anyway. While on Medicaid here in the District, an insured person is required to establish a particular primary case physician. This PCP is based at a specific location and is, of course, the person one sees in the event of a serious illness. I had meant to do this long before now and finally got around to it.
While on the phone with the scheduler I was asked a series of very rudimentary questions, as is typical. However, I have to say I was a bit blindsided by one of them, which I never would have expected in any context, for any reason. Do you identify as heterosexual, homosexual, or bisexual?
At first I thought the person on the line surely was joking, but he was quite serious. Of course I responded truthfully, but the request seemed more than a bit invasive. Don't get me wrong. I wish we could all be completely honest with ourselves, but providing what has been a very damning bit of my identity to a complete stranger for the sake of statistical analysis seems a bit forward. While part of me was relieved to note that bisexuality was being taken seriously---in that it was actually listed as a available answer choice, another part of me felt it severely inappropriate to even be asked such a thing.
At what point does our sexual orientation need to be anyone's public domain? Like many people, I've certainly often wondered what a truly accurate count of LGBTs would look like if fear and stigma were not an complicating factor. I myself have tried over time to give people the freedom and courage to come out. Still, I don't think I personally would ever feel comfortable confronting someone with such a bold request, especially a total stranger, in effect putting them on the spot. I've never been asked to state my sexual orientation before for any reason, and I can't help but think that those with a higher standard and quality of care are never asked such things.
The clinic that was closest to my home was one of the few sites in the District to take Medicaid patients. I'm sure that those with private plans likely don't have to take what they can get as I do. And I'm also sure if I dug deep enough into the matter or did my research I could find out the reasons why low-income residents are solicited for their sexual orientation. I do, however, worry that the information collected could be used in improper ways. Even in this day and age, they could be used for purposes of blackmail, regardless of how many times one is assured that the data collected is confidential.
The District has an unusually high number of residents who are HIV+ and live below the poverty line so perhaps this rather unorthodox request was put in place to best assist those who wish to prevent its spread. Yet, we seem to have no issue taking liberties that may compromise basic rights of privacy for those who don't have the same material and intellectual advantages that we do.
This country has a history of treating those at the bottom like guinea pigs. The most prominent example I can think of is the Tuskegee syphilis experiment, but the sheer magnitude of unethical human experimentation in this country alone is absolutely staggering. I am not implying that the information collected from me was taken in a spirit of medical sadism, but rather to note that it is often exceptionally easy to disregard freedom of choice in a rush to solve a problem. Manipulation of this sort is a slippery slope and while most practitioners stay within an ethical grey area, there are always a few here and there who take liberties.
As for me, I would have preferred to have been told upfront, before a single question had been asked, that I would be solicited for my sexual orientation. It's not so much the question itself I object to as the way it was presented and the lack of adequate methodology. I was not told how my answer would be recorded, what it was to be used for, that I was under no obligation to answer the question, and how my privacy was to be protected. In situations like these, careless record keeping easily ends up with personal information being compromised. We've all read about what happens when potentially sensitive personal data ends up being tossed into dumpsters without being shredded, or how easy it is for hackers to compromise even protected computer systems. Though it may be impossible to have a truly impenetrable system of defense, organizations and entities can still take safeguards to limit potential breaches.