Among the most sensitive – if not the most sensitive – information about us is our medical information. Each time we make an application to CASA Avmed for a medical certificate, we provide them yet more sensitive information.
Because of my concern for aviation safety in the real world, where Avmed’s increasingly overreaching behaviour is resulting in pilots being increasingly unwilling to disclose information to Avmed and – worse still – to seek medical advice on potential issues for fear that it will get back to Avmed – an outcome inimical to aviation safety - I entered into some correspondence with CASA’s privacy folk recently. My correspondence was precipitated by my recollection that, years ago, there was a ‘tick box’, on the medical certificate application form, which you could tick to consent to the information in the form being used in medical studies. That tick box has gone. These days we’re apparently simply “acknowledging” that our information – “deidentified” – can be used in “research” (and “internal audit”).
(This is one of the many reasons for my description of us medical certificate applicants as “guinea pigs”. Each time we’re sent off to some expensive and sometimes risky tests which qualified specialists say are not justified, it appears we’re providing more data to Avmed for “research”. My educated guess is that the results of the “research” are used to justify Avmed’s own existence and the ‘need’ to intrude into the ‘management’ of the ever-increasing number of ‘aero-medically relevant’ conditions they keep discovering. I anticipate the results are also the subject of Avmed conference echo chambers.)
For my part, I disclose my information for the purpose of, and only for the purpose of, being assessed against the statutory criteria for the issue of a medical certificate. I either meet those criteria or I don’t, and whether my information – deidentified or otherwise – is used in research is irrelevant to that question.
In essence, I asked how CASA got the job of using or disclosing our deidentified sensitive medical information for “research” purposes. I noted that the word “research” appears nowhere in CASA’s functions in the Civil Aviation Act. (CASA does have the function of, for example, cooperating with the Australian Transport Safety Bureau in relation to investigations under the TSI Act that relate to aircraft, and the ATSB can compel CASA to provide medical information about us in the course an investigation. There’s no deidentification required in that case, for obvious reasons.) CASA doesn’t have the corporate competence to do the jobs that are actually stated in the Civil Aviation Act – among the elephants in that room is “developing … concise aviation safety standards” – so better to focus on those than chasing medical research butterflies.
In essence, the CASA person’s response is that CASA has the function of using and disclosing our deidentified sensitive medical information for research purposes, and CASA can do that whether we consent to it or not.
I have raised this issue, among related issues, with the Office of the Australian Information Commissioner (OAIC).
Assuming CASA does have the function of using and disclosing our deidentified sensitive medical information for research purposes, and CASA can do that whether we consent to it or not, it raises the question as to
effectiveness of the procedures
used in fact by CASA to achieve deidentification. (
The OAIC has much to say on deidentification.) Given my first-hand experience in AAT matters against CASA and the content of CASA documents, disclosed under FOI, about how Avmed conducts itself, I have little faith in the effectiveness of whatever little governance arrangements are placed around Avmed’s activities.
I have submitted FOI requests to CASA in the following terms on Friday (18 Aug 2023):
All documents containing current CASA policy on and procedures for deidentification of originally sensitive medical information supplied by applicants for medical certificates, prior to disclosure or use by CASA for the purposes of research.
All documents containing information about the assessment of the effectiveness of CASA’s deidentification procedures, including the application of the ‘motivated intruder’ test, to mitigate the risks of reidentification of the individuals to whom the originally sensitive medical information relates.
All documents containing information about results of audits, conducted by auditors internal or external to CASA, of CASA’s compliance with CASA policy on and procedures for deidentification of originally sensitive medical information.
All documents containing information about the disclosure or use by CASA of deidentified originally sensitive medical information supplied by applicants for medical certificates, if the information in the documents includes any one or more or all of the following: The purpose of the disclosure or use of the deidentified information; the identity of the persons – natural or otherwise – to whom the deidentified information was disclosed; any description of the disclosed deidentified information; the results of the use to which the disclosed deidentified information was put.
I will keep everyone informed of the OAIC’s response and the outcomes of my FOI requests.