ACA Final Rule on Wellness Plans

By Leslie Francis

On May 29th, HHS issued the final rule governing wellness incentives in group health plans. While the incentives themselves are not a surprise, the scope they are given is worthy of ongoing attention. Wellness incentives have been controversial because of their potential for intrusion into individual choice, their subtle (or not so subtle) coerciveness, their valorization of a particularly model of health, and the possibility that they will impose differential burdens and costs on people with disabilities or other disfavored groups. The final rule attempts to meet these objections in several helpful ways.

Nonetheless, the final rule still will allow programs that are differentially burdensome as a result of factors other than health status. It will also allow programs under which it is more difficult for some than for others to obtain rewards because of their states of health. In programs that give rewards for health outcomes, alternatives must be available for those who do not meet targets—but the reasonableness standard for these alternatives permits requirements that may be differentially burdensome so if they are medically appropriate and follow the recommendations of the patient’s personal physician. HHS supports wellness programs as engaging individuals in their health, as encouraging them in healthy behaviors and discouraging them in unhealthy behaviors, and as incentivizing people to make use of recommended health care services such as screenings. Continue reading

Unapproved GMO wheat found in Oregon; Japan cancels US wheat imports.

By Nicholson Price

One fear about GMOs is that they will escape whatever controls are placed them and end up in the wild.  A version of that story appears to have come true in the wheat industry this week, when the USDA announced that farmers in Oregon had discovered an unexpected and unapproved patch of Roundup-Ready genetically modified wheat in a conventional wheat field.  Monsanto developed Roundup-Ready wheat (which is not resistant to its Roundup herbicide) and tested it between 1998 and 2005, but it was never approved for sale and was discontinued.  Japan has cancelled or suspended orders of wheat from the Pacific Northwest in response.

h/t to Grubstreet; see also recent posts on GMOs and the environment and on Monsanto’s patent protection of GMOs.

Science, Art, Policy, and the Importance of Good Science Communication

By Michelle Meyer 

Although I promised that I was done commenting on the artist-cum-policy wonk who claims to make 3-D “masks” of unknown individuals from their discarded DNA, Matthew Herper of Forbes has taken the criticisms of her (and the media covering her project) articulated by me and others directly to the artist. I confess that her response does not make me feel any better. Even if you’re “only” engaging in art, it seems to me that when that art has an obvious science policy message — indeed, one that you invite — you have some obligation to be clear about how “speculative,” as she puts it, your art is. But when you decide to move from the world of art into the world of science, and to start leading policy discussions based on your speculative art and working with forensic examiners? Then you really have a strong duty to be very clear about what your work can and cannot do. That means, among other things, taking care when talking with the media, and correcting the media if they get it wrong.

Yesterday, the Social Science Genetic Association Consortium, an international consortium that pools and conducts social science research on existing genome-wide association study (GWAS) data, and on whose Advisory Board I sit, published (online ahead of print) the results of its first study in Science. That paper — “GWAS of 126,559 Individuals Identifies Genetic Variants Associated with Educational Attainment” (plus supplemental data) — like much human genetics research, has the potential to be misinterpreted in the lay, policy, and even science worlds. That’s why, in addition to taking care to accurately describe the results in the paper itself, including announcing the small effect sizes of the replicated SNPs in the abstract, being willing to talk to the media (many scientists are not), and engaging in increasingly important “post-publication peer review” conversations on Twitter (yes, really) and elsewhere — we put together this FAQ of what the study does — and, just as important, does not — show. So far, our efforts have been rewarded with responsible journalism that helps keep the study’s limits in the foreground. Perhaps the DNA artist should consider issuing a similar FAQ with her speculative art.

Introducing Guest Blogger William MacAskill

William MacAskill is the Founder and President of 80,000 Hours, an advisory service for careers that make a difference. He is also the cofounder and Vice-President of Giving What We Can, a DPhil student in moral philosophy at Oxford University, a contributor to Quartz and The Atlantic, and has recently returned from Princeton on a Fulbright scholarship.


“Replaceability, Career Choice, and Making a Difference,” Ethical Theory and Moral Practice. Forthcoming.

“The Infectiousness of Nihilism,” Ethics. Forthcoming.

To save the world, don’t get a job at a charity; go work on Wall St,” Quartz (February 27, 2013).

The best advice you’ll never hear in a graduation speech,” Quartz (April 18, 2013).

Peter Singer, Ira W. DeCamp Professor of Bioethics at Princeton University, recently discussed Will’s work in his TED Talk, “The Why and How of Effective Altruism.”

Public Policy Considerations for Recent Re-Identification Demonstration Attacks on Genomic Data Sets: Part 1 (Re-Identification Symposium)

By Michelle Meyer

This post is part of Bill of Health‘s symposium on the Law, Ethics, and Science and Re-Identification Demonstrations. We’ll have more contributions throughout the week. Background on the symposium is here. You can call up all of the symposium contributions by clicking here. —MM

Daniel C. Barth-Jones, M.P.H., Ph.D., is a HIV and Infectious Disease Epidemiologist.  His work in the area of statistical disclosure control and implementation under the HIPAA Privacy Rule provisions for de-identification is focused on the importance of properly balancing competing goals of protecting patient privacy and preserving the accuracy of scientific research and statistical analyses conducted with de-identified data. You can follow him on Twitter at @dbarthjones.

Re-identification Rain-makers

The media’s “re-identification rain-makers” have been hard at work in 2013 ceremoniously drumming up the latest anxiety-inducing media storms. In January, a new re-identification attack providing “surname inferences” from genomic data was unveiled and the popular press and bloggers thundered, rattled and raged with headlines ranging from the more staid and trusted voices of major newspapers (like the Wall Street Journal’s: “A Little Digging Unmasks DNA Donor Names. Experts Identify People by Matching Y-Chromosome Markers to Genealogy Sites, Obits; Researchers’ Privacy Promises ‘Empty’”) to near “the-sky-is-falling” hysteria in the blogosphere where headlines screamed: “Your Biggest Genetic Secrets Can Now Be Hacked, Stolen, and Used for Target Marketing” and “DNA hack could make medical privacy impossible”. (Now, we all know that editors will sometimes write sensational headlines in order to draw in readers, but I have to just say “Please, Editors… Take a deep breath and maybe a Xanax”.)

The more complicated reality is that, while this recent re-identification demonstration provided some important warning signals for future potential health privacy concerns, it was not likely to have been implemented by anyone other than an academic re-identification scientist; nor would it have been nearly so successful if it had not carefully selected targets who were particularly susceptible for re-identification.

As I’ve written elsewhere, from a public policy standpoint, it is essential that the re-identification scientists and the media accurately communicate re-identification risk research; because public opinion should, and does, play an important role in setting priorities for policy-makers. There is no “free lunch”. Considerable costs come with incorrectly evaluating the true risks of re-identification, because de-identification practice importantly impacts the scientific accuracy and quality of the healthcare decisions made based on research using de-identified data. Properly balancing disclosure risks and statistical accuracy is crucial because some popular de-identification methods can unnecessarily, and often undetectably, degrade the accuracy of de-identified data for multivariate statistical analyses. Poorly conducted de-identification may fail to protect privacy, and the overuse of de-identification methods in cases where they do not produce meaningful privacy protections can quickly lead to undetected and life threatening distortions in research and produce damaging health policy decisions.

So, what is the realistic magnitude of re-identification risk posed by the “Y-STR” surname inference re-identification attack methods developed by Yaniv Erlich’s lab? Should *everyone* really be fearful that this “DNA Hack” has now made their “medical privacy impossible”? Continue reading

An Open Letter From a Genomic Altruist to a Genomic Extrovert (Re-Identification Symposium)

By Michelle Meyer

This post is part of Bill of Health‘s symposium on the Law, Ethics, and Science of Re-Identification Demonstrations. You can call up all of the symposium contributions here. We’ll continue to post contributions throughout the week. —MM

Dear Misha:

In your open letter to me, you write:

No one is asking you to be silent, blasé or happy about being cloned (your clone, however, tells me she is “totally psyched”).

First things first: I have an ever-growing list of things I wish I had done differently in life, so let me know when my clone has learned how to read, and I’ll send it on over; perhaps her path in life will be sufficiently similar to mine that she’ll benefit from at least a few items on the list.

Moving on to substance, here’s the thing: some people did say that PGP participants have no right to complain about being re-identified (and, by logical extension, about any of the other risks we assumed, including the risk of being cloned). It was my intention, in that post, to articulate and respond to three arguments that I’ve encountered, each of which suggests that re-identification demonstrations raise few or no ethical issues, at least in certain cases. To review, those arguments are:

  1. Participants who are warned by data holders of the risk of re-identification thereby consent to be re-identified by third parties.
  2. Participants who agree to provide data in an open access format for anyone to do with it whatever they like thereby gave blanket consent that necessarily included consent to using their data (combined with other data) to re-identify them.
  3. Re-identification is benign in the hands of scholars, as opposed to commercial or criminal actors.

I feel confident in rejecting the first and third arguments. (As you’ll see from the comments I left on your post, however, I struggled, and continue to struggle, with how to respond to the second argument; Madeleine also has some great thoughts.) Note, however, two things. First, none of my responses to these arguments was meant to suggest that I or anyone else had been “sold a bill of goods” by the PGP. I’m sorry that I must have written my post in such a way that it leant itself to that interpretation. All I intended to say was that, in acknowledging the PGP’s warning that re-identification by third parties is possible, participants did not give third parties permission to re-identify them. I was addressing the relationship between re-identification researchers and data providers more than that between data providers and data holders.

Second, even as to re-identification researchers, it doesn’t follow from my rejection of these three arguments that re-identification demonstrations are necessarily unethical, even when conducted without participant consent. Exploring that question is the aim, in part, of my next post. What I tried to do in the first post was clear some brush and push back against the idea that under the PGP model — a model that I think we both would like to see expand — participants have given permission to be re-identified, “end of [ethical] story.” Continue reading

Too Young for Sex, But Old Enough for the Sex Offender Registry, Part II

By Michele Goodwin

This post is the second in a three part series on the use of criminal law to police teen sex.  The first part can be viewed here.

In recent years, thousands of judicial proceedings against children result in teens as young as thirteen being adjudicated as sexual predators and placed on sex offender registries.  The problem in the United States is that statutory rape laws create per se rule violations with respect to all sexual intercourse involving children.  My research reveals that children as young as 11 have been prosecuted as both the victim and sex offender.  In some states, even sexual touching involving consenting minors breaks the law. In other words, sex with a person under the age of majority or age of consent (depending on the specific state legislation) is always crime.  In a recently published Wisconsin Law Review article found here, I argue that such prosecutions can and often do lead to absurd results.

In Utah, which serves as a relative example, a child who commits “more than five ‘separate acts’ of sexual touching,” even without sexual penetration, could be convicted for “aggravated sexual abuse of a child.” In South Dakota, a minor can be adjudicated a delinquent and guilty of first-degree rape for one act of sexual penetration, regardless of consent if the consenting party is under thirteen.. Wisconsin’s statutory rape law reads similarly. These matters are particularly thorny in their application against children because legally a child cannot consent to sexual intercourse. In some states, including Utah, adolescent fondling constitutes sexual abuse of a child just as attempts to touch the buttocks, breasts, or “intent to arouse or gratify the sexual desire.” Even consenting children will always be deemed “victims” in states that take this approach.

According to the CDC, nearly 50% of high school teenagers have had sexual intercourse.  In fact, by the 9th grade over 30% of girls and nearly 40% of boys have had sex.  In conservative states like Mississippi and South Carolina, pre-teen boys report the highest rates of pre-teen sex (19.1% and 17.1%, respectively).   Along with reporting sexual activity, white teens report the highest rates of combining sex with alcohol.

CDC studies expose the gaps in how parents view and understand youth sexuality. An American Broadcasting Company (ABC) News survey investigating parental and teens attitudes on sex places has some startling findings.  Consider this: while nearly ninety percent of parents surveyed confirmed that they spoke with their teens about sex, only forty nine percent of teens believed such conversations took place.

However, adolescent sexual activity raises questions for the law.  Should teens be prosecuted for committing the crime of rape if they engage in consensual sexual intercourse with children of their own or near age?  Is it ethical to prosecute children similarly to adults for having sex with other children?  More to come in Part III.



Worth Reading This Week

By Nicolas Terry

More on Liability for Failure to Vaccinate

As of Friday, June 28, this post is closed to further comments. We want to thank the many readers who have engaged in a vigorous and civil discussion on the recent posts to the Bill of Health that engage questions related to the debate over vaccines. In general, we do not moderate discussions on the site. However, due to an increasing number of comments that violate our policies regarding abusive and defamatory language and the sharing of personal information, we are closing these posts to comment.

Art Caplan discusses his recent Bill of Health post over at WBUR’s Here and Now.  Take a listen.

Monsanto v. Bowman: Patents on GMO Seeds

By Nicholson Price

Monsanto has been receiving quite a bit of press recently.  Marchers in over 400 cities protested the company and the GMOs it makes took place a few days ago, arguing that foods should be labeled if they contain GMOs.

More broadly relevant to the biotech industry and GMOs generally, a few weeks ago, the Supreme Court released its 9-0 opinion in Bowman v. Monsanto, No. 11-796.  This case shores up the patent-law foundation for the GMO seed business (as was widely expected), but also takes an interesting turn involving intent and self-replicating technology in general. Continue reading


According to an article in the NYT, an artist has collected DNA samples from litter on sidewalks, such as chewing gum and cigarette butts, and used those samples to extract and sequence DNA that she then used to make computer models of their owners’ faces. She then printed 3-D masks that she is showing at her upcoming exhibit called Stranger Visions. The artist hopes her exhibit will spark a dialogue over genetic surveillance.

The NYT article explains that

[w]hile staring at the wall of her therapist’s office, the artist Heather Dewey-Hagborg noticed a strand of hair stuck in a hanging print. Walking home, she noticed that the subways and sidewalks were littered with genetic material on things like chewing gum and cigarette butts, some still moist with saliva. Curious about what she could learn, Ms. Dewey-Hagborg began to extract and sequence DNA from these discarded materials. Then — and here it gets a little eerie — she began to make computer models of their owners’ faces, using genetic clues to print 3-D masks that she concedes “might look more like a possible cousin than a spitting image.” Hanging these portraits along with the original samples, she says, is “a provocation designed to spur a cultural dialogue about genetic surveillance.” After the June exhibitions, Ms. Dewey-Hagborg will show her work early next year at the New York Public Library. She has also collaborated on a tongue-in-cheek project called DNA spoofing, which purports to offer ordinary people some techniques to avoid detection by scrambling their genetic material.

Talk and exhibition at Genspace in Brooklyn on June 13. Exhibition at QF Gallery in East Hampton, N.Y., opens June 29.

[Cross-posted from HealthLawProf Blog]

A Decade’s Quest for Safer Drugs: Congressional Committee Green Lights Regulation of Drug Supply Chains and Compounding Manufacturers

By Mary Ann Chirba and Alice A. Noble

On May 22. 2013, the Senate Health, Education, Labor and Pensions (HELP) Committee unanimously approved S.959, “The Pharmaceutical Compounding Quality and Accountability Act,” and S.957, “The Drug Supply and Security Act,” (now incorporated into S. 959 as an amendment).  Congressional efforts to enact comprehensive legislation to improve drug safety and secure the nation’s drug supply chain have lingered for over a decade. The lack of federal uniformity has allowed a patchwork of state legislation to emerge, attracting the less scrupulous to those states with the lowest security. The issue finally gained traction among HELP Committee members when 55 people died and 741 more became ill after contracting fungal meningitis from contaminated steroid injections made by the New England Compounding Center (NECC). Committee member Sen. Pat Roberts (R-KS) stated that given prior reports of problems with NECC, this tragedy could have been averted but for a “shocking failure to act” by NECC, state and federal regulators, and Congress.

As NECC’s role in the meningitis outbreak came to light,gaps in regulatory oversight did, too. The federal Food Drug and Cosmetic Act (FDCA)[1] currently recognizes only two categories of pharmaceutical manufacturers: commercial pharmaceutical companies and compounding pharmacies. To qualify as the latter under federal law, the entity must make individual or small batch, patient-specific drugs and do so only with a physician’s prescription for that patient.  Compounded drugs must be either be unavailable in the commercial market or needed in commercially unavailable doses or combinations. The FDCA exempts such compounders from its pre-marketing requirements applicable to commercially manufactured drugs. Thus, federal law clearly covers commercial pharmaceutical manufacturers, state law just as clearly oversees and licenses pharmacies but as the NECC case demonstrates, there is nothing clear about the responsibility for inspecting, licensing or otherwise overseeing compounders that do not fill prescriptions on a per patient basis.

Instead of compounding in response to an individual prescription, the New England Compounding Center made large batches of drugs for institutional buyers such as hospitals. Many of its drugs were commercially unavailable but some were knock-offs of marketed FDA-approved drugs – a practice which is clearly unauthorized. NECC’s business model was certainly not unique; neither was the limited and erratic response of state and federal regulators to complaints about the facility’s unsafe manufacturing practices. Congress knew that large-scale compounders existed along with concerns about their safety. Several members of the Senate HELP Committee had worked on curative legislation for over ten years, but made few inroads until the NECC crisis prompted the  HELP Committee to shift from park into drive.

Continue reading

Reidentification as Basic Science (Re-Identification Symposium)

By Michelle Meyer

This post is part of Bill of Health‘s symposium on the Law, Ethics, and Science of Re-Identification Demonstrations. You can call up all of the symposium contributions here. We’ll continue to post contributions into next week. —MM

Arvind Narayanan (Ph.D. 2009) is an Assistant Professor of Computer Science at Princeton. He studies information privacy and security and has a side-interest in technology policy. His research has shown that data anonymization is broken in fundamental ways, for which he jointly received the 2008 Privacy Enhancing Technologies Award. Narayanan is one of the researchers behind the “Do Not Track” proposal. His most recent research direction is the use of Web measurement to uncover how companies are using our personal information.

Narayanan is an affiliated faculty member at the Center for Information Technology Policy at Princeton and an affiliate scholar at Stanford Law School’s Center for Internet and Society. You can follow him on Twitter at @random_walker.

By Arvind Narayanan

What really drives reidentification researchers? Do we publish these demonstrations to alert individuals to privacy risks? To shame companies? For personal glory? If our goal is to improve privacy, are we doing it in the best way possible?

In this post I’d like to discuss my own motivations as a reidentification researcher, without speaking for anyone else. Certainly I care about improving privacy outcomes, in the sense of making sure that companies, governments and others don’t get away with mathematically unsound promises about the privacy of consumers’ data. But there is a quite different goal I care about at least as much: reidentification algorithms. These algorithms are my primary object of study, and so I see reidentification research partly as basic science.

Continue reading

I Never Promised You a Walled Garden (Re-Identification Symposium)

This post is part of Bill of Health‘s symposium on the Law, Ethics, and Science of Re-Identification Demonstrations. You can call up all of the symposium contributions here. We’ll continue to post contributions into next week. —MM

By Misha Angrist

Dear Michelle:

You know I respect your work immensely: your paper on the heterogeneity problem will be required reading in my classes for a long time to come.

But as far as this forum goes, I feel like I need both to push back and seek clarity. I’m missing something.

As you know, the PGP consent form includes a litany of risks that accompany the decision to make one’s genome and medical information public with no promises of privacy and confidentiality. These risks range from the well documented (discovery of non-paternity) to the arguably more whimsical (“relatedness to criminals or other notorious figures.”), including the prospect of being cloned. You write:

Surely the fact that I acknowledge that it is possible that someone will use my DNA sequence to clone me (not currently illegal under federal law, by the way) does not mean that I have given permission to be cloned, that I have waived my right to object to being cloned, or that I should be expected to be blasé or even happy if and when I am cloned.

Of course not. No one is asking you to be silent, blasé or happy about being cloned (your clone, however, tells me she is “totally psyched”).

But I don’t think it’s unfair to ask that you not be surprised that PGP participants were re-identified, given the very raison d’être of the PGP.

I would argue that the PGP consent process is an iterative, evolving one that still manages to crush HapMap and 1000 Genomes, et al., w/r/t truth in advertising (as far as I know, no other large-scale human “subjects” research study includes an exam). That said, the PGP approach to consent is far from perfect and, given the inherent limitations of informed consent, never will be perfect.

But setting that aside, do you really feel like you’ve been sold a bill of goods? Your deep–and maybe sui generis–understanding of the history of de-identification demonstrations makes me wonder how you could have been shocked or even surprised by the findings of the Sweeney PGP paper.

And yet you were. As your friend and as a member of the Board of Directors, this troubles and saddens me. In the iterative and collaborative spirit that the Project tries to live by, I look forward to hearing about how the PGP might do better in the future.

In the meantime, I can’t help but wonder: Knowing what you know and having done your own personal cost-benefit analysis, why not quit the PGP? Why incur the risk?

Warm regards,


Reflections of a Re-Identification Target, Part I: Some Information Doesn’t Want To Be Free (Re-Identification Symposium)

This post is part of Bill of Health‘s symposium on the Law, Ethics, and Science of Re-Identification Demonstrations. You can call up all of the symposium contributions here. Please note that Bill of Health continues to have problems receiving some comments. If you post a comment to any symposium piece and do not see it within half an hour or so, please email your comment to me at mmeyer @ and I will post it. —MM

By Michelle N. Meyer

I wear several hats for purposes of this symposium, in addition to organizer. First, I’m trained as a lawyer and an ethicist, and one of my areas of scholarly focus is research regulation and ethics, so I see re-identification demonstrations through that lens. Second, as a member of the advisory board of the Social Science Genetics Association Consortium (SSGAC), I advise data holders about ethical and regulatory aspects of their research, including issues of re-identification. I may have occasion to reflect on this role later in the symposium. For now, however, I want to put on my third hat: that of data provider to (a.k.a. research participant in) the Personal Genome Project (PGP), the most recent target of a pair of re-identification “attacks,” as even re-identification researchers themselves seem to call them.

In this first post, I’ll briefly discuss my experience as a target of a re-identification attack. In my discussions elsewhere about the PGP demonstrations, some have suggested that re-identification requires little or no ethical justification where (1) participants have been warned about the risk of re-identification; (2) participants have given blanket consent to all research uses of the data they make publicly available; and/or (3) the re-identification researchers are scholars rather than commercial or criminal actors.

In explaining below why I think each of these arguments is mistaken, I focus on the PGP re-identification demonstrations. I choose the PGP demonstrations not to single them out, but rather for several other reasons. First, the PGP attacks are the case studies with which, for obvious reasons, I’m most familiar, and I’m fortunate to have convinced so many other stakeholders involved in those demonstrations to participate in the symposium and help me fill out the picture with their perspectives. I also focus on the PGP because some view it as an “easy” case for re-identification work, given the features I just described. Therefore, if nonconsensual re-identification attacks on PGP participants are ethically problematic, then much other nonconsensual re-identification work is likely to be as well. Finally, although today the PGP may be somewhat unusual in being so frank with participants about the risk of re-identification and in engaging in such open access data sharing, both of these features, and especially the first, shouldn’t be unusual in research. To the extent that we move towards greater frankness about re-identification risk and broader data sharing, trying to achieve clarity about what these features of a research project do — and do not — mean for the appropriateness of re-identification demonstrations will be important.

Having argued here about how not to think about the ethics of re-identification studies, in a later post, I plan to provide some affirmative thoughts about an ethical framework for how we should think about this work.

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GM Crops and the Environment

By Joanna Sax

I’ve become increasingly interested in GM crops, in general, after the recent Petrie-Flom Conference on the FDA in the 21st Century.

I know there is a lot of discussion and controversy about genetically-modified (GM) crops.  I want to pick-up on a topic that is related to GM crops – that is, the environment.  The May 2nd issue of Nature includes a special section on GM crops.  Part of this section provides information on the environmental advantages of GM crops.  Most of the GM crops contain DNA that allows them to be resistant to herbicides or insects.  It turns out that a study showed that there was a 6.1% reduction in the use of herbicide between 1996 and 2011 on crops of herbicide-resistant cotton compared to the amount of herbicide that would have been used to treat conventional crops.  See Natasha Gilbert, A Hard Look at GM Crops, 497 Nature 24, 25 (2012) (I believe this article is free if you search for it on the Nature website).  A reduction in the amount of herbicide used to treat our fabric or food sources may have environmental advantages.  Less herbicide run-off into waterways.  Less herbicide for animals to consume.  See id.

Other scientific data provide inconclusive results about environmental impacts.  Some studies look at whether transgenes are spreading to weeds or non-GM crops.  For example, husbandry techniques of cross-breeding may unknowingly cross breed a non-transgenic line with a transgenic line and thereby create a transgenic line.  Now, a GM crop will be grown without the farmer even knowing it.  See id. at 24, 26.  And, if the GM crop has some sort of negative environmental impact, then a farmer may unwittingly be creating potential harm to the environment.

One thing I want to raise with this post is the importance to incorporate multiple areas of study – biology, environmental studies, genetics, health, regulation, etc. – to determine how we advance our understanding of GM crops.  I imagine that many readers of this blog are much more familiar with GM crops than me, so I welcome your comments.

More Commentary on Why Patients May Be Discriminated Against

Given my recent piece in the New England Journal on discrimination against patients, particularly obese patients in the context of the Americans with Disabilities Act, I found this NY Times story particularly interesting: Disability and Discrimination at the Doctor’s Office. The Times story focuses on patients who are disabled in more traditional ways, but indicates that the main culprit behind the medical discrimination they may experience is not animus, but rather lack of proper equipment, which can be quite expensive.  Luckily, there may be hope on the horizon, thanks to the ACA.

PFC Student Internship Applications Due in 1 Week!

The Petrie-Flom Center for Health Law Policy,
Biotechnology, and Bioethics at Harvard Law School
Call for Applications
Student Internship Program


The Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School is seeking student interns for the upcoming academic year beginning in September 2013.   Full-year availability is preferred, but single-term internships will be considered on an individual basis; please indicate your preference in your application materials. We are not currently accepting applications for Summer 2013, but may consider extension through Summer 2014 if there is mutual interest.

Who is eligible?

Harvard undergraduate and graduate students with an interest in the Center’s work are eligible to apply. More information about the Center is available here. The internship is open to students in all disciplines, but we particularly welcome applications from students studying health policy, philosophy, bioethics, law, medicine, business economics, and the sciences.  We are also interested in receiving applications from students interested in technology and communications, as we plan to substantially update and expand our Internet presence and social media strategy.

Continue reading

Data Sharing vs. Privacy: Cutting the Gordian Knot (Re-Identification Symposium)

PGP participants and staff at the 2013 GET Conference. Photo credit:, license CC-BY

This post is part of Bill of Health‘s symposium on the Law, Ethics, and Science of Re-Identification Demonstrations. You can call up all of the symposium contributions here. Please note that Bill of Health continues to have problems receiving some comments. If you post a comment to any symposium piece and do not see it within half an hour or so, please email your comment to me at mmeyer @ and I will post it. —MM

By Madeleine Ball

Scientists should share. Methods, samples, and data — sharing these is a foundational aspect of the scientific method. Sharing enables researchers to replicate, validate, and build upon the work of colleagues. As Isaac Newton famously wrote: “If I have seen further it is by standing on the shoulders of giants.”

When scientists study humans, however, this impulse to share runs into another motivating force — respect for individual privacy. Clinical research has traditionally been conducted using de-identified data, and participants have been assured privacy. As digital information and computational methods have increased the ability to re-identify participants, researchers have become correspondingly more restrictive with sharing. Solutions are proposed in an attempt to maximize research value while protecting privacy, but these can fail — and, as Gymrek et al. have recently confirmed, biological materials themselves contain highly identifying information through their genetic material alone.

When George Church proposed the Personal Genome Project in 2005, he recognized this inherent tension between privacy and data sharing. He proposed an extreme solution: cutting the Gordian knot by removing assurances of privacy:

If the study subjects are consented with the promise of permanent confidentiality of their records, then the exposure of their data could result in psychological trauma to the participants and loss of public trust in the project. On the other hand, if subjects are recruited and consented based on expectation of full public data release, then the above risks to the subjects and the project can be avoided.

Church, GM “The Personal Genome Project” Molecular Systems Biology (2005)

Thus, the first ten PGP participants — the PGP-10 — identified themselves publicly.

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Breaking Good: A Short Ethical Manifesto for the Privacy Researcher

This post is part of Bill of Health‘s symposium on the Law, Ethics, and Science of Re-Identification Demonstrations. We’ll have more contributions throughout the week, and extending at least into early next week. Background on the symposium is here. You can call up all of the symposium contributions here (or by clicking on the “Re-Identification Symposium” category link at the bottom of any symposium post).

Please note that Bill of Health continues to have problems receiving some comments. If you post a comment to any symposium piece and do not see it within half an hour or so, please email your comment to me at mmeyer @ and I will post it. —MM

By Yaniv Erlich

1. Increase the general knowledge –Like any other scientific discipline, privacy research strives to increase our knowledge about the world. You are breaking bad if your actions are aimed to reveal intimate details of people, or worst to exploit these details for your own benefit. This is not science. This is just ugly behavior. Ethical privacy research aims to deduce technical commonalities about vulnerabilities in systems not about the individuals in these systems. This should be your internal compass.

This rule immediately asserts that your published findings should communicate only relevant information to deduce general rules. Any shocking/juicy/intimate detail that was revealed during your study is not relevant and should not be included in your publication.

Some people might gently (or aggressively) suggest that you should not publish your findings at all. Do not get too nervous by that. Simply remind them that the ethical ground of your actions is increasing the general knowledge. Therefore, communicating your algorithms, hacks, and recipes is an ethical obligation and without that your actions cannot be truly regarded as research. “There is no ignorabimus … whatever in natural science. We must know — we will know!”, the great Mathematician David Hilbert once said. His statement applies also to privacy research.

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