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Digital tools to diagnose and treat patients evoke four conceptualizations of privacy. An interest in spatial privacy feels violated as the home becomes a site of digital observation and surveillance, inviting a scheme of protections geared to the traditional privacy of the home. Yet many information theorists reject location-based privacy schemes and favor control-over-information theory, stressing people’s rights to notice and consent before disclosing or using their identifiable information. US medical privacy law, including the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, rejects control-over- information theory and is more aptly portrayed as a Nissenbaumian contextual privacy scheme directed at one specific context: Clinical health care (as opposed to health-related transactions outside the clinical context). A fourth alternative would be a uniform scheme of content-based privacy regulations that stratifies the level of privacy protection based on inherent data characteristics (e.g. data about health) without regard to where in the overall economy the data are generated and stored. The European Union (EU)’s General Data Protection Regulation (GDPR) and the California Consumer Privacy Act aspire (with partial success) to extend uniform protections. This chapter examines these four visions of privacy and considers their advantages and possible drawbacks when applied to home health care. After comparing the four alternatives, the chapter recommends norms of privacy and data access for digital tools used in home care settings.
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