The Privacy Paradox

Feb. 12, 2006
FORUM ASIDThe Privacy ParadoxHow much privacy or seclusion is enough? How much is too much?by Linda Elliott Smith, FASIDOn a recent visit to my doctor's office, I sat and filled out forms that would allow or disallow certain individuals to have access to information relative to my medical condition. These forms—one of the many by-products of the Health Insurance Portability and Accountability Act of 1996, better known as HIPAA—are intended to protect my medical privacy. I appreciate that. Nonetheless, as the names of patients were being called out in the reception area, I wondered why I was allowed to know who else was seeing the doctor, and yet my family members could not be told I was here unless I pre-approved them to receive that information.Later, as I stood behind a line drawn on the floor in the pharmacy (presumably to prevent me from overhearing any conversation that an individual might be having with the pharmacist regarding a prescription or medical condition), I found myself wondering where this quest for privacy gets us. How much privacy does that line really provide? On the other hand, adult children concerned for their aging parents' health are not allowed access to medical information without pre-approval from the parents, even though a parent may have a poor understanding of his or her medical condition or may be cognitively impaired.Our society is living in a paradox when it comes to privacy. We don't want others to know anything about our health conditions, prescriptions, treatments, etc., and yet one can sit in a busy airport or other public space and overhear individuals openly disclosing intimately personal details over cellular telephones as though no one else was there to hear. We worry about identity theft, but willingly give up information about ourselves to get supermarket discounts. We resent individuals prying into our affairs, but compete to go on television and tell the world anything and everything about ourselves. The constant through all these conflicting attitudes toward privacy appears to be control. We want to be the ones who determine when and where we disclose information about ourselves. This issue is becoming critical in a number of environments, in addition to healthcare. In the workplace, for instance, we are working in smaller and smaller cubicles and in closer proximity to one another. Add to this the proliferation of data screens, speaker phones, cell phones, team workspaces and mobile workstations, along with fewer wholly-enclosed offices and poor sound masking. Protecting one's privacy, as well as shielding oneself from others' conversations, has become a daily battle that increases stress, diminishes productivity and lowers job satisfaction.In other environments, such as law offices, call centers, public libraries and human resource departments, protecting confidential and sensitive data is as essential as it is in the healthcare field. There is no HIPAA-like legislation for these arenas as yet in the U.S., but Canada and many other countries throughout the world already have passed national privacy legislation. Some states in the U.S. have already passed their own legislation concerning some types of privacy. It seems only a matter of time before national legislation is called for in the U.S. as well. As design professionals, we must begin to look deeper at the elemental issues of privacy: acoustical, visual and data privacy. The changes resulting from the implementation of HIPAA have made clear that we are going to be charged with creating solutions to these issues in how we design public and, to some extent, private spaces. The difficulty we will face is in finding the delicate balance between how much privacy or seclusion is enough and how much is too much. How much control can be given to individuals without impinging on the control of another?To better understand how these issues are evolving and how designers are already responding to them, ASID asked a panel of top interior designers and privacy experts about current privacy concerns and effective solutions for addressing them. From these interviews were derived a set of principles (see box) to help guide future privacy design. To obtain a copy of the report, In the Open: How Design Can Protect Privacy, visit the ASID Web site at and click on "Research and Publications" on the home page.Linda Elliott Smith is president of education-works, inc. in Dallas, TX, and serves as president of ASID. She has served the society in a number of volunteer positions for more than 20 years. ASID can be reached at (202) 546-3480; fax: (202) 546-3240;

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