Law in the Internet Society

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LouisEnriquezSaranoFirstEssay 4 - 12 Dec 2020 - Main.LouisEnriquezSarano
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Living in the Matrix

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One fulcrum in the fight to “reclaim” the net is the struggle to articulate what we have lost. While popular awareness of the threat posed by behavior collection firms (BCFs) is surely widening, the most popular metaphor today is still Orwell’s Big Brother. But that metaphor impedes the development of a unified theory of privacy because it fails to capture autonomy harms that are distinct from behavior collection and influence.

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A key fulcrum in the fight to “reclaim” the net is the struggle to articulate what we have lost. While popular awareness of the threat posed by behavior collection firms (BCFs) is surely widening, the most popular metaphor today is still Orwell’s Big Brother. But that metaphor impedes the development of a unified theory of privacy because it fails to capture autonomy harms that are distinct from behavior collection and influence.
 One of the Big Brother paradigm’s most glaring weaknesses is its failure to convey the colonization of the human body by large medical technology and insurance firms (BigMed? ). Examining this development, alongside BCFs’ colonization of the human mind, yields a far more complete picture of the threats posed to human autonomy by the PwtMoG? . That picture is aptly described by comparison to the movie The Matrix—it illustrates how the PwtMoG? ’s holistically exploits our minds and bodies to produce profit while simultaneously deceiving us.

At first blush this metaphor may seem facetious; but rallying activists and the broader public around a more compelling, less abstract, articulation of the PwtMoG? is a crucial step toward building political momentum. It may also encourage a unified, rather than piecemeal, transformation of the net into one that protects our autonomy instead of exploiting our vulnerabilities.

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1 Big Brother and Big Other

As others have already noted, the weakness of the Big Brother metaphor is that it only draws attention to a particular type of threat posed by the PwtMoG? . It conjures the watchful eye: The government watching us through security cameras, Google reading our emails, etc. Thus people could be forgiven for believing that net’s only real threat is that it lets strangers learn things about us that we would rather keep secret.

More recently, the popular conversation has come to consider BCFs’ broader threats to our autonomy. Popular movies examine how social media became a tool BCFs use to influence where we go, what we do, what we buy, and even how we vote. Shoshanna Zuboff called this phenomenon “Big Other,” expanding the metaphor to demonstrate that Google, Facebook, et al. are not merely peeping Toms but part of “the sensate, computational, connected puppet that renders, monitors, computes, and modifies human behavior.” (The Age of Surveillance Capitalism 293). But “Big Other,” is a bit less rhetorically powerful than Big Brother, and in any event only marginally more descriptive of the totality of the danger presented by PwtMoG? .

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1. Big Brother and Big Other

 
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2 The EHR and the Colonization of Human Bodies

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As others have noted, the weakness of the Big Brother metaphor is that it only draws attention to a particular type of threat posed by the PwtMoG? . It conjures the watchful eye: The government watching us through security cameras, Google reading our emails, etc. Thus, people could be forgiven for believing that net’s only real threat is that it lets strangers learn things about us that we would rather keep secret.
 
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The PwtMoG? ’s infiltrated the human body in many ways, but none as all-consuming as the electronic health records (EHR). Through the EHR BigMed? is engaged in a continual bodily harvest distinct from the BCFs’ behavioral harvest—not least because it takes place in the shadow of HIPAA, a law meant to protect individual privacy.
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More recently, the popular conversation has come to consider BCFs’ broader threats to our autonomy. Popular movies examine how social media became a tool BCFs use to influence where we go, what we do, what we buy, and even how we vote. Shoshanna Zuboff called this phenomenon “Big Other,” expanding the Big Brother metaphor to demonstrate that Google, Facebook, et al. are not merely peeping Toms but part of “the sensate, computational, connected puppet that renders, monitors, computes, and modifies human behavior.” (The Age of Surveillance Capitalism, 293). But “Big Other,” is a bit less rhetorically powerful than Big Brother, and in any event only marginally more descriptive of the totality of the danger presented by PwtMoG? .
 
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The modern electronic health record (EHR) owes its widespread use to 2009’s Health Information Technology for Economic and Clinical Health Act (HITECH). Following its passage EHR adoption by physicians increased from around 10% to 90%. EHRs contain patients’ vital signs, medical histories, family histories, immunization records, radiological images, test results and more. They were are well-suited to the surveillance economy, which relies on simultaneous economies of scale and scope (Zuboff, 95, 201). The largest BigMed? firms have hundreds of millions of patient medical records. These firms have amassed billions of dollars by refining EHR data and selling it to pharmaceutical firms. (Tanner, Our Bodies Our Data: How Companies Make Billions Selling Our Medical Records 3–4 (2017)).
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2. The EHR and the Colonization of Human Bodies

 
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BigMed? ’s modus operandi is no different from that of any other of the PwtMoG? ’s arms. But mechanically speaking, it has been empowered and, critically, shielded from scrutiny, by HIPAA. That is because HIPAA focused only on preventing healthcare providers from disseminating patients’ identities accompanied by sensitive medical information and not on governing the actual use of that information, not to mention individual patients’ rights in their EHRs as meaningful representations of their bodies. By restricting the flow of EHR data, except for “healthcare operations,” treatment, or payment, it directs EHR data towards BigMed? . Meanwhile it blesses the unregulated sale of de-identified data. Together these provisions form a data pipeline (the exceptions) and a moat (the prohibition on other transfers of data), securing BigMed? ’s hold on the EHR data market.
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The PwtMoG? has infiltrated the human body in many ways, but the most important, and perhaps least well known, avenue is the electronic health records (EHR). Through the EHR BigMed? is engaged in a continual bodily harvest distinct from the BCFs’ behavioral harvest—not least because it takes place in the shadow of HIPAA, a law meant to protect individual privacy.
 
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The punchline is that via our EHRs BigMed? profits from our bodies without our consent or knowledge—two foundational principles of autonomy. More distressing is that our conception of the PwtMoG? as Big Brother/Other totally fails to capture this bodily colonization, thereby shielding it from the outrage directed at the exploitation of human minds.
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The modern electronic health record (EHR) owes its widespread use to 2009’s Health Information Technology for Economic and Clinical Health Act (HITECH). Following its passage EHR adoption by physicians increased from around 10% to 90%. EHRs contain patients’ vital signs, medical histories, family histories, immunization records, radiological images, test results and more. They were well-suited to the surveillance economy, which relies on simultaneous economies of scale and scope (Zuboff, 95, 201). The largest BigMed? firms have aggregated hundreds of millions of patient medical records and amass billions of dollars by refining EHR data and selling it to pharmaceutical firms. (Tanner, Our Bodies Our Data: How Companies Make Billions Selling Our Medical Records, 3–4).
 
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3 Living in the Matrix

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BigMed? ’s modus operandi is no different from those of the PwtMoG? ’s other arms. But mechanically speaking, it has been empowered and, critically, shielded from scrutiny, by HIPAA. That is because HIPAA focused only on preventing healthcare providers from disseminating patients’ identities when transacting sensitive medical information and not on regulating the actual use of that information—it goes without saying that HIPAA was certainly not designed to protect individual patients’ rights in their EHRs as meaningful representations of their bodies. By restricting the flow of EHR data, except for “healthcare operations,” treatment, or payment, it directs EHR data towards BigMed? . Meanwhile it blesses the unregulated sale of de-identified data. Together these provisions form a data pipeline (the exceptions) and a moat (the prohibition on other transfers of data), securing BigMed? ’s hold on the EHR data market.
 
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Conveying the breadth of the PwtMoG? ’s infiltration of both human minds and bodies lies at the heart of swaying public opinion and preserving our autonomy and our bodily freedom. The best I can offer is The Matrix. In the film humans are cultivated to produce energy for the machine overlords. Meanwhile their minds are connected to a vast simulation meant to lull them into submission. It captures the exploitation of both human bodies and minds, the sentience of the networked threat, and the lie of our apparently harmless online world. The metaphor is, of course, imperfect. But it draws attention to the true nature of the PwtMoG? and in doing so, pushes us towards solutions that comprehensively preserve freedom from exploitation.
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The punchline is that via our EHRs BigMed? profits from our bodies without our consent or knowledge—two foundational principles of autonomy. More distressing is that our conception of the PwtMoG? as Big Brother/Other totally fails to capture this bodily colonization, thereby shielding BigMed? from the outrage we direct at the BCFs.
 
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3. Living in the Matrix

 
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Conveying the breadth of the PwtMoG? ’s infiltration of both human minds and bodies lies at the heart of swaying public opinion and preserving our autonomy and our bodily freedom. The best I can offer is The Matrix. In the film humans are cultivated to produce energy for the machine overlords. Meanwhile their minds are connected to a simulation that lulls them into submission. The movie captures the exploitation of both human bodies and minds, our lack of control over the diffuse threat, and the lie of our apparently harmless online world. The metaphor is, of course, imperfect. But it draws attention to the true nature of the PwtMoG? and in doing so, pushes us towards solutions that comprehensively preserve freedom from exploitation.
 
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Revision 4r4 - 12 Dec 2020 - 06:58:53 - LouisEnriquezSarano
Revision 3r3 - 11 Dec 2020 - 07:24:11 - LouisEnriquezSarano
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