Redefining Medical Confidentiality in the Digital Era: Healthcare Reform and the West German Debate over the Use of Personal Medical Information in the 1980s

In a book published in 2012 to great ballyhoo, the American cardiologist Eric Topol painted a shimmering, seductive picture of how the "super-convergence" of "the rapidly maturing digital, nonmedical world of mobile devices, cloud computing, and social networking with the emerging digital medical world of genomics, biosensors, and advancing imaging" was leading to the "creative destruction of medicine." The targets of his polemic—one where information and technology cast no shadows—were an "ossified" medical profession, a lengthy and prohibitively expensive drug approval policy, and population-based medicine, whose standardized, cookie-cutter approach insured that, more often than not, treatment would miss its mark. Glimmering on Topol's horizon was a "knowledge of individuals so fine-grained that we can speak of a science of individuality," and he hoped that in the wake of this super-convergence would follow a "rebooted life science industry [that] would leverage the science of individuality… [and get] the relevant digital readout from a person to fashion a therapy, instead of a mass-population—directed strategy."1¹

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