Western societies generally recognize both a legal and a moral right to privacy. However, at the present time there is no settled opin ion in the United States regarding how these rights should relate to medical information. On the one hand, virtually everyone agrees that one' s medical records should not be open to just any interested person' s inspection. On the other hand, most also agree that some sacrifices in medical privacy are necessary for scientific advancement, public health protection, and other social goals. However, what limits should be set upon those sacrifices, and how those limits should be determined, have long been issues of debate. In recent years this debate has intensified. There are a variety ofreasons for this; to mention only three: (1) Over the years the US health care delivery system has become increasingly complex, and with this complexity there has come a need for more and more people to have access to patients' medical records. With each transference of information, breaches in confidentiality become more likely. (2) Medical costs have risen at an alarming rate. This makes health insurance a virtual necessity for adequate medical care, and people worry that they will be denied employment and/or medical cov erage if certain sorts of medical information are not kept strictly confi dential. (3) Finally, many medical records are now kept in computer files, and the impossibility of guaranteeing confidentiality for files of this sort is a constant worry.
