Abstract
This essay discusses the performative effects of the public–private distinction on digital data infrastructures in healthcare. The words ‘public’ and ‘private’ hold many meanings. This analysis focuses on how they are used both in an informational sense (what is kept secret or strictly controlled versus what is out in the open or shared) and an institutional sense (issues of ownership and purpose such as being state-owned and governed for the common good or privately owned and aimed at generating profit). In the political construction of digital infrastructures, the two senses are deeply intertwined: changes in relation to ownership and purpose affect what is kept secret and what is shared. Furthermore, when policymakers search for ways to protect one aspect (privacy) they sometimes opt for tools from the other (by conceiving of data as private property). The informational interconnectedness facilitated by digital infrastructures produces a form of ‘data promiscuity’. Data promiscuity is a condition where data are indiscriminate in the choice of partners: what is seen as data on a thing for one purpose can always become seen as data on another aspect of that thing and be used for another purpose and by another user. Data are set free to pursue gain or pleasure, but this freedom involves certain dangers for the persons from whom they derive. Data promiscuity is the contemporary condition of possibility for health research. By unpacking the wholesale categories of public and private through which the contemporary situation came about, there is a better chance of rethinking the problems it involves, and for suggesting new solutions to ensure social sustainability. The argument is based on developments in one of the most fiercely digitalised and datafied countries in the world: Denmark.
Highlights
In the course of just a few decades, pervasive digitalisation has facilitated an unprecedented datafication of many aspects of modern life (Ruckenstein and Schüll, 2017; van Dijck, 2014)
I suggest that these changes have been influenced by the work of a public–private distinction that social scientists and political actors use to describe societal problems, as well as to invent political solutions
The public–private distinction, describes problems and solutions; it prescribes them by way of shaping policy thinking
Summary
In the course of just a few decades, pervasive digitalisation has facilitated an unprecedented datafication of many aspects of modern life (Ruckenstein and Schüll, 2017; van Dijck, 2014). While the public–private distinction is used in many senses,1 two of them stand out in relation to digital data sharing (Ariès, 1989; Johansen and Andrews, 2016); one relating to informational aspects (what is kept secret or strictly controlled versus what is out in the open or shared) and the other to institutional issues of ownership and purpose (typically seen as a matter of being stateowned and governed for the common good, or privately owned and aimed at generating profit).
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