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New Legislation Will Allow Control Of Medical Treatment

By David South

Today’s Seniors (Canada), December 1993

It isn’t the nicest thing to think about, but if accident or illness strikes, you could end up receiving unwanted treatment. 

But in 1994 things will change. The living will or advance directive – a document clearly stating a patient’s wishes about how they want to be treated – will become part of the doctor-patient relationship. 

A trio of acts passed last December – the Advocacy Act, the Substitute Decisions Act and the Consent to Treatment Act – allow, albeit in rather vague language, for Ontarians to set out in advance which medical procedures they would or wouldn’t accept and let’s them name a proxy in case they are incapable of expressing their wishes. 

This vague language – intended to allow patients to customize their wishes – means that writing a living will can prove to be a troubling and confusing experience. 

To aid decision-making, the University of Toronto Centre for Bioethics is offering advice through a “model” living will. 

The centre’s Dr. Peter Singer has geared the “model” to meet Ontario legislation and to offer a guide for anybody who doesn’t know where to begin. 

“We put a lot of detail in the advance directive about states of incompetence people get into, and also the sorts of procedures providers might recommend in those health states.”

Singer sees living wills as an effective tool aiding patients to control their own health care.

“Unless the doctor is a longstanding friend it’s hard to know what patients want. As a practicing doctor, I have run into an incompetent person where their family member has no idea what sort of wishes the person would have wanted. The goal of a living will is to provide the personal care the patient would want.”

But there is a danger. Dr. Singer urges the need for informed and detailed language in a living will. 

“If I have a couple minutes to make a decision I need a document that gives me a lot of confidence that this person wouldn’t want this treatment.”

In an emergency, the doctor might not even know of the living will’s existence. Dr. Singer advises giving a copy to your family doctor, lawyer, or proxy, and keep one with you at all times. When so-called “smart” health cards come along, Dr. Singer would like to see the living will recorded on the magnetic strip along with other health information. 

Read more health and medical journalism here: Taking Medicine To The People: Four Innovators In Community Health

Read more about transforming medical history scholarship in Canada here: Hannah Institute For The History Of Medicine | 1992 – 1994

More from Canada’s Today’s Seniors

Feds Call For AIDS, Blood System Inquiry: Some Seniors Infected

Government Urged To Limit Free Drugs For Seniors

Health Care On The Cutting Block: Ministry Hopes For Efficiency With Search And Destroy Tactics

New Seniors’ Group Boosts ‘Grey Power’: Grey Panthers Chapter Opens With A Canadian Touch

Seniors Falling Through The Health Care Cost Cracks

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Categories
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What is the UN doing with your data?

2011

France24: UN among victims of massive cyber-spying campaign

“Cyber-security experts have unveiled one of the biggest computer hacking campaigns to date, releasing a list of 72 organisations whose networks were attacked over a five-year period. Victims include the UN and several governments.

REUTERS – Security experts have discovered the biggest series of cyber attacks to date, involving the infiltration of the networks of 72 organizations including the United Nations, governments and companies around the world. … 

In the case of the United Nations, the hackers broke into the computer system of its secretariat in Geneva in 2008, hid there for nearly two years, and quietly combed through reams of secret data, according to McAfee.”

2017

June

BBC: Accenture and Microsoft plan digital IDs for millions of refugees

December

UNHCR: ID2020 and UNHCR Host Joint Workshop on Digital Identity

2019

June

Xinhua: China, UN to build big data research institute in Hangzhou

2020

January

The New Humanitarian: EXCLUSIVE: The cyber attack the UN tried to keep under wraps

“If there are no consequences for the [UN] agencies for failures like these … there will be more breaches.”

About this investigation:
While researching cybersecurity last November, we came across a confidential report about the UN. Networks and databases had been severely compromised – and almost no one we spoke to had heard about it. This article about that attack adds to The New Humanitarian’s previous coverage on humanitarian data. We look at how the UN got hacked and how it handled this breach, raising questions about the UN’s responsibilities in data protection and its diplomatic privileges.

https://www.forbes.com/sites/daveywinder/2020/01/30/united-nations-confirms-serious-cyberattack-with-42-core-servers-compromised/?sh=4cb9c05d633d

April

Quartz: The UN is partnering with China’s biggest surveillance software company

Foreign Policy: EXCLUSIVE U.N.: Backs Down on Partnership With Chinese Firm for 75th Anniversary: The decision comes after U.S. officials and human rights advocates complained that Tencent aids Beijing in surveillance.

October

WSJ Opinion: China Uses the U.N. to Expand Its Surveillance Reach | In the name of ‘sustainable development,’ Beijing takes the lead in data collection efforts.

December

United Nations: Inauguration Ceremony Regional Hub for Big Data in China in support of the United Nations Global Platform

“I am very honoured to join you today in this inauguration ceremony of the Regional Hub for Big Data in China, in support of the United Nations Global Platform. The inauguration of this Regional Hub is most important, and timely. 

The demand for data, especially during the COVID-19 pandemic, is greater than ever.  Governments are in need of detailed data on the spread of the virus and its impacts on society. Under these challenging circumstances, statistical institutes have had to respond urgently to the demand for data, and to present innovative solutions. Consequently, in these times of need, the statistical community is now able to effectively use Big Data and advanced technologies. 

For example, census data – together with detailed geospatial information – can help identify the most vulnerable populations during the pandemic. And, real-time data on the position and movement of ships, for example, can estimate the volume of cargo being transported, and thus help produce estimates on the state of the economy. These real-time shipping data are available as a global data set on the United Nations Global Platform, and can be accessed by the whole statistical community.”

2021

January

ITPro: United Nations suffers potential data breach: Hackers could have breached the database long before the UN applied a patch

March

Financial Times: Opinion Technology sector: As digital trade grows, so does western distrust of Beijing: China is moving to the forefront of global innovation but governments fear privacy breaches

April

Nikkei Asia: Comment: Data suspicions threaten to tear China and west apart: Applications by Chinese companies see 200-fold increase since 1999

May

UNHCR: Government of Pakistan delivers first new biometric identity smartcards to Afghan refugees

July

ODI: Although shocking, the Rohingya biometrics scandal is not surprising and could have been prevented

“The data privacy and security of Rohingya refugees in Bangladesh has reportedly been jeopardised by the UN Refugee Agency. In an exposé published on 15 June by Human Rights Watch (HRW), UNHCR stands accused of improperly collecting the Rohingya’s biometric information and later sharing it with the Myanmar government without the Rohingya’s consent. Refugees said they had been told to register to receive aid, but the risks of sharing their biometrics had not been discussed, and the possibility this information would be shared with Myanmar was not mentioned.

The potential harm of sharing information with a regime that has a long history of manipulating registration systems to exclude and marginalise Rohingya populations is obvious. That biometrics are involved makes it worse. Unlike names or other personal information, biometrics are sticky – it’s not something you can change or escape.”

August

Reuters: ANALYSIS-Afghan panic over digital footprints spurs call for data collection rethink

Biometric Update: Concerns over Taliban accessing aid agency biometric data

“People in Afghanistan are fearful of the Taliban accessing personal information captured and stored by aid agencies including biometric data which could be used to identify individuals. Experts have raised concern that approaches used by security firms and United Nations development agencies could prove problematic for refugees and vulnerable groups, reports the Thomson Reuters Foundation, the charitable trust of Thomson Reuters.

The Intercept reported that equipment used by the U.S. army for biometric collection has already been seized by the Taliban. Biometric data on Afghans who assisted the U.S. were widely collected, making anybody identified vulnerable to persecution from the Taliban.

Sources told the Intercept that there was little planning for such an event, while the U.S. Army plans to continue to spend another $11 million on biometrics capture equipment including 95 more devices.

The UNHCR has been using biometrics in the region since 2002 when it tested iris recognition technology on Afghan refugees in the Pakistani city of Peshawar. Aid agencies praise biometric technology’s anti fraud and contactless capabilities.”

“Unique Identity for All”: Biometric identity is being rolled out across the planet. HSB is one of the many players in this fast-growing data collection sector. Companies such as HSB collect data on behalf of international organisations.
This story is from 1992 and is a rare glimpse into Canada’s data sharing agreements with the US and other countries.

Data integrity and cross-border data sharing have been concerns for a very long time. False Data Makes Border Screening Corruptible

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Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021