154 journal of law, medicine & ethics
The Journal of Law, Medicine & Ethics, 47 S2 (2019): 154-158. © 2019 The Author(s)
DOI: 10.1177/1073110520917041
Privacy and Security Issues
with Mobile Health Research
Applications
Stacey A. Tovino
Introduction
This article examines the privacy and security issues
associated with mobile application-mediated health
research, concentrating in particular on research con-
ducted or participated in by independent scientists,
citizen scientists, and patient researchers. Building on
other articles in this issue that examine state research
laws and state data protection laws as possible sources
of privacy and security protections for mobile research
participants,
1
this article focuses on the lack of appli-
cation of federal standards to mobile application-
mediated health research. As discussed in more detail
below, the voluminous and diverse data collected by
some independent scientists who use mobile appli-
cations to conduct health research may be at risk for
unregulated privacy and security breaches,
2
leading
to dignitary, psychological, and economic harms for
which participants have few legally enforceable rights
or remedies under current federal law.
3
Federal law-
makers may wish to consider enacting new legislation
that would require otherwise unregulated health data
holders to implement reasonable data privacy, secu-
rity, and breach notification measures.
Background
Privacy and security are fundamental aspects of the
ethical conduct of research involving human partici-
pants. Adopted by the World Medical Association
(WMA) in 1964, the Declaration of Helsinki estab-
lished a duty of physicians who are involved in medi-
cal research to protect “privacy … and confidentiality
of personal information of research subjects.”
4
Consis-
tent with the mandate of the WMA, the Declaration of
Helsinki is addressed primarily to physician-research-
ers,
5
but it also “encourages others who are involved in
medical research involving human subjects to adopt
these principles.”
6
First prepared by the Council for International
Organizations of Medical Sciences (CIOMS) in col-
laboration with the World Health Organization in
1982, the International Ethical Guidelines for Health-
Related Research Involving Humans (Guidelines)
address the use of “data obtained from the online envi-
ronment and digital tools.”
7
In particular, the current
(2016) Guidelines provide:
When researchers use the online environment
and digital tools to obtain data for health-related
research they should use privacy-protective
measures to protect individuals from the
possibility that their personal information is
directly revealed or otherwise inferred when
datasets are published, shared, combined or
linked. Researchers should assess the privacy
risks of their research, mitigate these risks as
much as possible and describe the remaining
risks in the research protocol. They should
anticipate, control, monitor and review
interactions with their data across all stages of
the research.
8
The Guidelines also state that researchers should,
through an “opt-out procedure,” inform persons
whose data may be used in the context of research in
the online environment of the purpose and context of
the intended data uses, the privacy and security mea-
sures used to protect such data, and the limitations
of the measures used and the privacy risks that may
Stacey A. Tovino, J.D., Ph.D., is the Judge Jack and Lulu
Lehman Professor of Law at the William S. Boyd School of
Law, University of Nevada-Las Vegas.