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Steve Talbott’s book Devices of the Soul: Battling for Our Selves in the Age of Machines is difficult reading, both for the truths embedded in it, as well as the tedious exaggerations he deploys in his scathing critique of digital technology, the internet and mostly all things virtual. Yet there is much to consider here, especially in his short, but poignant, chapter on digital privacy.

Some excerpts so you can get the drift of what he sees coming:

The battle for privacy, waged upon the fields of data, will be lost. . .

. . . the ideal of privacy gains substance only in those primary contexts where we know each other well enough to care. . . Lacking such contexts, we cannot win; we will be assimilated to the realities of our technology, where one data bit looks just like another and there can be no special protection for any of them.

Issues of personal respect don’t arise between packets of data, nor between information processing programs.

Rather we will have an endless contest between privacy-protecting software and privacy-invading software.

Within the global information system every piece of data is perilously close to being globally exposed . . .

If privacy is to emerge as a meaningful public value, it will be in the context of community involvement. Where else can we learn what needs respecting about each other, if not from a knowledge of the other person in particular and of the requirements of a healthily functioning community in general.

Here’s a simple principle to consider: if you are clearing the way for a new form of data transaction, or proposing some new mechanism for data privacy, then spend at least three times as much effort working towards a means for strengthening community outside those data contexts. Otherwise, you may well be helping to destroy the essenial milieu for any privacy worth having.

So how do we think about Talbott’s arguments when it comes to health care? Several challenges quickly come to mind.

• How do we sensitize large institutions that manage medical information to the concerns of the community? In other words, how do we get medical institutions to care?
• The emergence of ubiquitous computing in health care — RFID tags, remote sensing, medical surveillance and the like — presents special challenges when it comes privacy. Where is the community context for this technology?
• What about privacy in the 2.0 world, where health information divulged in one social media, is collected for say commercial use in another?

Health care, as I have said many times, is the poster child for digital privacy issues.