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Should Community Rights Override Individual Rights to Privacy?

A Book Review

By Sheldon Richman
January 22, 2001

Amitai Etzioni, professor of sociology at George Washington University, is the leading popularizer of the philosophy he calls "responsive communitarianism." As he writes in The Limits of Privacy, "responsive communitarianism seeks to balance individual rights with social responsibilities, and individuality with community." In this volume he applies his philosophy to the matter of privacy. Unsurprisingly, he sees a "basic tension between our profound desire for privacy and our deep concern for public safety and public health." He concludes, "We need to treat privacy as an individual right that is to be balanced with concerns for the common good--or as one good among others, without a priori privileging any of them."

Time to Swing the Pendulum?

Etzioni believes that privacy in many areas (including HIV testing, e-mail encryption, national identity cards and biometric identifiers) is overemphasized to the detriment of public health and safety. It's time, he writes, to swing the pendulum back to a more reasonable position.

Later I will show that Etzioni's approach to privacy rests on an act of fundamental question-begging. But first let's consider his views on privacy with regard to medical issues.

Readers will be pleased to learn that Etzioni thinks there is insufficient consideration for privacy in the matter of medical records. He decries the unauthorized and, more important, abusive authorized access to people's medical information. He calls for more protection of privacy and thinks it can be done without sacrificing such "common goods" as research, quality control, and cost containment. He outlines several methods to guard medical privacy, including self-regulation, sophisticated computer applications, smart cards, and the like. These would permit wide "legitimate" access to anonymous data, while restricting access to information in which patients can be identified.

Who is a Bigger Threat?

We can applaud Etzioni for worrying about threats to medical privacy, but beware. He believes the private sector (that is, people who want to sell you things) is a bigger threat than the government! For him, government is a big part of the solution. He seems to favor the unique health identifier authorized by Congress. Significantly, he rejects the principle of informed consent as rooted in individualism, inferior to his communitarian approach, and impractical. Indeed, he thinks it is neither informed nor consent because to obtain health insurance, people must sign standard blanket consent forms that "impose no limits on what is to be disclosed or to whom, or on the release of personal health information to third parties or the sale of such information to all comers."

Etzioni commits a fallacy here. Simply because the principle of informed consent is imperfectly implemented is no proof that it is defective. He takes no notice of the fact that most medical care is paid for by third parties, either the government or insurance companies. Of those who rely on insurance for even the most routine medical attention, most have their coverage through their employers. That paternalistic practice is the result of wartime wage controls and a tax policy that penalizes those who buy their own insurance. This results in a crippled medical marketplace that lacks what John Goodman calls patient power, or cost-consciousness. If people were responsible for finding their own coverage, they would scrutinize the terms more closely and a truly competitive market would push companies to offer consent agreements that conform to the preferences of consumers.

Instead of favoring free markets and contracting for confidentiality, which cannot be matched for sensitivity to individual preferences, Etzioni prefers the state--which is notorious for its one-size-fits-all approach to things.

In the end, Etzioni's solutions are unsatisfactory for a simple reason: he is trying to shoehorn solutions into a flawed philosophical framework. The premise that individual rights must be balanced with the common good begs the main questions: What rights do individuals begin with? How can "society" determine the extent of those rights when society is a collection of individuals? There is the crux: Etzioni treats the community as an organism that makes decisions and has interests that can override those of individuals.

But only individuals choose, act, and pursue interests. Thus the principle that "the community" should balance individual rights and the common good is a euphemism for mob rule.

Once the individual's preeminent place is recognized, his natural rights, especially property rights, are up to the task of distinguishing legitimate from illegitimate privacy claims.

Sheldon Richman is editor of Ideas on Liberty, published by the Foundation for Economic Education.

The Limits of Privacy by Amitai Etzioni was published by Basic Books in 1999 (215 pages plus notes and index).

This article was originally published in the November/December 2000 issue of Health Freedom Watch.