Rev Derecho Genoma Hum. 2004 Jul-Dec(21):127-38.
Mr. R appealed for a decision by the Court to overturn the refusal of the Medical Director of Health to her request that health information in medical records pertaining to herdeceased father should not be entered into the Health Sector Database. Furthermore, she called for recognition of her right to prohibit the transfer of such information into a database. Article 8 of Act No 139/1998 on a Health Sector Database provides for the right of patients to refuse permission, by notification to the Medical Director of Health, for information concerning them to be entered into the Health Sector Database. The Court concluded that R could not exercise this right acting as a substitute of her deceased father, but it was recognised that she might, on the basis of her right to protection of privacy, have an interest in preventing the transfer of health data concerning her father into the database, as information could be inferred from such data relating to the hereditary characteristics of her father which might also apply to herself. It was revealed in the course of proceedings that extensive information concerning people's health is entered into medical records, e.g. medical treatment, life-style and social conditions, employment and family circumstances, together with a detailed identification of the person that the information concerns. It was recognised as unequivocal that the provisions of Paragraph 1 of Article 71 of the Constitution applied to such information and guaranteed to every person the right to protection of privacy in this respect. The Court concluded that the opinion of the District Court, which, inter alia, was based on the opinion of an assessor, to the effect that so-called one-way encryption could be carried out in such a secure manner that it would be virtually impossible to read the encrypted data, had not been refuted. It was noted, however, that Act No. 139/1998 provides no details as to what information from medical records is required to be encrypted in this manner prior to transfer into the database or whether certain information contained in the medical records will not be transferred into the database. The documents of the case indicate that only the identity number of the patient would be encrypted in the database, and that names, both those of the patient and his relatives, as well as the precise address, would be omitted. It is obvious that information on these items is not the only information appearing in the medical records which could, in certain cases, unequivocally identify the person concerned. Act No. 139/1998 also provides for authorisation to the licensee to process information from the medical records transferred into the database. The Act stipulates that certain specified public entities must approve procedures and process methods and monitor all queries and processing of information in the database. However, there is no clear definition of what type of queries will be directed to the database or in what form the replies to such queries will appear. The Court concluded that even though individual provisions of Act No 139/1998 repeatedly stipulate that health information in the Health Sector Database should be non-personally identifiable, it is far from adequately ensured under statutory law that this stated objective will be achieved. In light of the obligations imposed on the legislature by Paragraph 1 of Article 71 of the Constitution, the Court concluded that various forms of monitoring of the creation and, operation of the database are no substitute in this respect without foundation in definite statutory norms. In light of these circumstances, and taking into account the principles of Icelandic law concerning the confidentiality and protection of privacy, the Court concluded that the right of R in this matter must be recognised, and her court claims, therefore, upheld.
R女士请求法院作出裁决,推翻卫生医疗主任拒绝其请求的决定,该请求是要求不将与其已故父亲相关的医疗记录中的健康信息录入卫生部门数据库。此外,她呼吁承认其禁止将此类信息转移至数据库的权利。1998年第139号《卫生部门数据库法案》第8条规定,患者有权通过通知卫生医疗主任拒绝允许将涉己信息录入卫生部门数据库。法院认定,R女士不能以其已故父亲的替代者身份行使这一权利,但承认基于其隐私权,她可能有利益诉求以阻止将与其父亲相关的健康数据转移至数据库,因为从此类数据中可能推断出与其父亲遗传特征相关的信息,而这些特征可能也适用于她自己。诉讼过程中显示,大量有关人们健康的信息被录入医疗记录,例如治疗情况、生活方式和社会状况、就业及家庭情况,以及所涉人员的详细身份信息。宪法第71条第1款的规定明确适用于此类信息,并保障每个人在这方面的隐私权,这一点得到公认。法院认定,地方法院的意见,尤其是基于一名评估员的意见,即所谓的单向加密能够以如此安全的方式进行,以至于几乎不可能读取加密数据,这一意见未被推翻。然而,需要指出的是,1998年第139号法案未详细说明医疗记录中的哪些信息在转移至数据库之前需要以这种方式加密,或者医疗记录中某些信息是否不会被转移至数据库。案件文件表明,数据库中仅会对患者的身份号码进行加密,而患者及其亲属的姓名以及确切地址将被省略。显然,这些项目的信息并非医疗记录中仅有的在某些情况下能够明确识别相关人员的信息。1998年第139号法案还授权被许可人处理转移至数据库的医疗记录中的信息。该法案规定,某些特定的公共实体必须批准程序和处理方法,并监督数据库中所有信息查询和处理情况。然而,对于将向数据库提出何种类型的查询,或者此类查询的回复将以何种形式出现,并没有明确的定义。法院认定,尽管1998年第139号法案的个别条款多次规定卫生部门数据库中的健康信息应无法识别个人身份,但在成文法下,远未充分确保实现这一既定目标。鉴于宪法第71条第1款对立法机关施加的义务,法院认定,在缺乏明确法定规范基础的情况下,对数据库创建和运行的各种形式监督在这方面并不能替代法定规范。鉴于这些情况,并考虑到冰岛法律中关于保密和隐私保护的原则,法院认定必须承认R女士在该事项上的权利,因此支持她向法院提出的诉求。