Public Bodies, Private Selves

ABSTRACT A patient whose case notes had been used, without her permission, during a disciplinary inquiry on the conduct of Wendy Savage (her obstetrician) complained that this was a breach of confidentiality. Her complaint cannot be understood as based on a concern about the possible adverse consequences of this use of the notes: rather, her concern was just with the fact that medical information about her had been made known to others.
My concern is with the meaning and status of the right to privacy, to which the Savage patient appealed. Such a right cannot be reduced to a property right, since this cannot capture what concerned the Savage patient. A proper understanding of what lies behind her complaint requires us to recognise the way in which facts about oneself—in this case facts about one's body—are intimately bound up with one's self, with one's identity, and thus with one's autonomy. What kinds of fact, and thus what conception of the self, are involved in such a conception of privacy need not everywhere be the same; the crucial point is that privacy and the self are concepts which, whatever their particular content, are internally related [1].