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Abstract

This Article describes how dominant technology firms have revolutionized the healthcare industry in only a few years. Now, medical treatment and research are predicated on constant, decentralized data collection, prediction and personalization, and algorithmic judgments. The new digital health paradigm implicates issues of privacy, bias, autonomy, equity, and discrimination. Yet Big Tech has been quick to justify its new practices as an opportunity for better care, quicker discovery of cures, and ultimately, lives saved. Moreover, many medical practitioners welcome this healthcare revolution as a chance to deemphasize the importance of patient privacy and autonomy in American bioethics and prioritize the free flow of medical information to improve health systems. Whatever the merits of the new regime, current legislation is ill-suited for a data-driven approach to healthcare because it leaves gaps in regulation and harms unaddressed. This Article argues that while reform is necessary, new regulation should not reflexively guard patient privacy. Rather, any legislative response must also account for other concerns like bias, equity, autonomy, and collective benefit. These considerations are often at odds with one another, and tradeoffs are unavoidable. This Article offers a framework for evaluating new digital healthcare tools in the context of these conflicting fundamental values, accounting for harms and benefits at both the individual and societal level. Finally, this Article suggests a number of legislative requirements necessary for any regulation to adequately respond to the digital health revolution.

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