Map of life expectancy at birth from Global Education Project.

Wednesday, May 20, 2009

Storebror ser dig.

According to Google translation, that's Swedish for Big Brother is watching you. Perhaps our hordes of Swedish readers can correct me if necessary.

Anyway, Seena Fazel and various people with diacritical marks over their vowels inform us in the new JAMA that schizophrenia is associated with violent crime in the presence of comorbid substance abuse, but otherwise hardly at all or maybe not even. This appears to explain some contradictory findings of earlier studies, and it is helpful in formulating policies to assess and address the risks that people with serious mental disorders may pose to themselves and others. (You're good enough to read the abstract, anyway.)

That's interesting, but what I found provocative about the study was the means by which they were able to figure this out. It turns out that in Sweden, there is a 10-digit personal identification number, similar to our Social Security number. However, beyond that, there are complete national registries, using said ID, for hospital discharges; criminal convictions; the national census; the "multigeneration register" which links you to your parents and siblings; causes of death; and emigration/immigration. As for the crime registry, there is no plea bargaining in Sweden, and not guilty by reason of insanity is still guilty enough to go into the register, as are remands to mental hospitals and sentences short of incarceration. They had to proactively exclude traffic tickets and non-violent crimes such as passing bad checks -- it's all in there. The hospital discharge registry contains all diagnoses, including psychiatric labels, substance abuse disorders, and presumably whatever embarassing stuff you can think of be it fecal incontinence, genital herpes, or toenail fungus.

All this turns out to be very useful for social epidemiology, and evidently the Swedes aren't too worried about it being misused. But imagine if Dick Cheney and Alberto Gonzalez had all of that to work with. What do you think? Good idea, or not so good idea?


Anonymous said...

The swedes are also right up there in their study of traffic and accidents, for the same reason.

It is a question of trust, really. If you are sure your personal data is used only for the common good, such as fix social policy for the withdrawal of drving licenses (just as an ex.) and that you remain an anonymous blip on a screen, where is the harm?

In Switz. it is common to study institutiions and do reports, with a guarantee of anonymity for the participants /respondents. Nobody ever refuses, because it is understsood that even if the respondents can be identified (often possible) nothing will come of it. A guarantee of anonimity is such, even if the anonimity is not guaranteed.


Cervantes said...

Thanks Ana. I'm afraid we have a very different political reality here.

roger said...

don't "they' already have all of our communications recorded? am i to suppose that only lowly clerks looked at octomom or farrah fawcett's medical records?

the cat is already out of the bag and into the secret database. i can almost hear the titters of whoever has to read through our blogs.

let's just have it out in the open so we can use the info constructively.