US Privacy vs. Cuba’s Socialization
Graham Sowa
Everyone who wants to practice medicine in the United States must pass the United States Medical Licensing Exam (USMLE). One of my friends, who attends medical school in the United States, recently took this exam. When I asked about her results the exchange went like this:
Me: “What did you get on the USMLE?”
Friend: “I did very well.”
Me: “How well did you do?”
Friend: “Good enough to get into a residency that I want”
Me: “But what was your score?”
Friend: “It’s not polite to ask that!”
This conversation, and the reaction from my friend it provoked, is normal amongst students from the United States, even from those who study in Cuba.
Cuban academic culture is the opposite. Exam results are read out or published by name. This is not only to embarrass or chide, but also to let the professor and fellow students see where the weaknesses and strengths are in the group.
Even individuals in Cuba don’t extend privacy to their academic results. If I ask any of my Cuban friends “How did you do on your exam?” they will tell me their exact score. And it is not impolite to ask.
Individual students and academic culture treat student test scores differently based on the different expectations of privacy in each country.
Americans seem to be addicted to individual privacy. We are paranoid about ownership of our information, as if everything we have gleaned from life was of our own doing to which we retain exclusive rights.
When questioned about the why we need privacy most Americans will answer to one or both of these effects: fear of government and/or fear of corporations. To hold these fears without specific cause is pompous.
It is to assume that 1984 and A Brave New World are not novels, but successful social projects of a perfect elite bent on altering the morally pure protagonist. Individual Americans value privacy because they value themselves more than society. Protecting privacy for its own sake is not a solution to our self-centeredness; it is a symptom of it.
But the American value of privacy is neither universal nor simple, it is complicated by hypocrisy. There is an expectation, mainly by those that beat their chests over individual privacy protection, that governments and corporations should operate openly at all times.
When the editor-in-chief of Wired, a technology and society magazine, published a defense of wikileaks “Why Wikileaks is Good for America” his argument’s claim was that Wikileaks will make American democracy better. In terms of privacy: an exposure of information deemed private by the United States Government is a good thing.
But like many who advocated on behalf of Wikileaks Wired does not feel the same way about personal privacy. In the article “Facebook’s Gone Rouge” the same magazine argues that Facebook has violated the privacy of users by not allowing enough mechanisms for blocking which people can see what information we post on the social network.
The argument seems to be that we should be able to eliminate all variables from social life by being able to control every aspect of what is known about us and who knows it. Anyone with a post-enlightenment understanding of scientific variables will realize that this is wholly unattainable.
Wired, and others who cannot decide on their definition of open society, need to recognize that the success of American democracy is also contingent on openness among citizens. Limiting knowledge in a social setting for the sake of privacy alone is not good for government, corporations, or individuals.
Even with our privilege to engage in digital social networking like Facebook and Twitter I find that Cubans are much more informed about their immediate social surroundings than we are.
Our remedy should not be an abandonment our widely held idea of a ‘right to privacy,’ but we do need to recognize that just because we believe in this right does not make privacy a requirement or even a necessity.
Those of us in the medical profession should be acquainted with the benefits and necessity of abandoning privacy. When we do a clinical exam we completely divulge a person. We know the frustration of having a patient who is not forthright and open in our pursuit of their history.
Patients who guard their privacy keep us from achieving good health outcomes. But how can we blame those noncompliant patients when our same value of privacy keep us from telling each other our exam scores?
To Julie Webb-Pullman and Cubano loco, very well said!
It seems that Graham Sowa is confusing US society–where bandits and commercial piranha are swarming everywhere, trying to find and devour the vulnerable–with Cuban society where such predation is much less prevalent, or is non-existent. It’s easy to sympathize with him however because his vision is of how society truly ought to be.
Dear Graham, if we are able to achieve the socialist Cooperative Republic within the next decade, as we hope to do, you will see a society begin to develop in which people can be much more open without such fear of predation. In the meantime, good luck with your studies.
Interesting observation, first this american friend is not really a friend of yours. He/she is quite hard businessmen already how never shows its card to anyone. What you learn about a free society cannot be created within an capitalist environment, where theft and lie is the main factor to get rich, long before hard work. Of course many say it was hard work to lie so much.
But there are lots of good people in US who have not lost their common sense, but much less of them in the first generation of exiles who left after their protector Batista was gone.
Information is power, and can be used for good, and not so good. Health practitioners’ situation regarding information is more complex than your description, involving two fundamentally different perspectives, one as the recipient of information necessary for optimal treatment, and the second regarding who they share that information with. There is an enormous difference between the two – the patient divulging information to a health practitioner attempting to assist, and the practitioner passing that patient’s information on to a third party/ies. The widely-accepted principle guiding the sharing of information by third parties, especially authorities, is the ‘need to know’. Thus, health practitioners should only share that information with other treating personnel who need to know it in order to provide optimal treatment.
If a patient feels they cannot trust the practitioner to keep their information confidential, they are far more likely to fail to disclose it, especially if it could have negative repercussions on their life. Does the receptionist – or the next patient – ‘need to know’ the patient just picked up an STI? No. Could that information unnecessarily and unjustifiably damage the patient’s family and social life and relationships? Yes. Is doctor-patient trust essential to a good therapeutic relationship? Absolutely.
The bottom line is that personal information is right up there with private property, and according to the Universal Declaration of Human Rights, we all have the right to it, not withstanding the ‘need-to-know’ principle (another example being income disclosure for taxation purposes). It is a patient’s decision as to who they share diagnoses and treatment with, and has nothing to do with individuality versus collectivism, and everything to do with upholding human rights.
I personally think the same principles as in other spheres like taxation and health care should apply to examination results – the ‘need to know.’ Why does anyone else ‘need to know’ your results? A university needs the information, a scholarship-awarder might, but other students? Questionable. If a one student doesn’t want to tell you, another student, their results, they obviously have their own reasons for it. Why do you even want to know? Power….if they are your friend they will probably share the information with you, if not – suck it up, it’s obviously none of your business.
What is the difference between God and doctors? God doesn’t think s/he is a doctor……