Big Brother and Singaporean "Medicine".

Singapore is generally known as a "police state", to the rest of the world. In one way, this is an odd description, because one rarely sees actual policemen and women in Singapore. However, what people are referring to, when they label Singapore as a "police state" is, partially, the degree of surveillance of the citizens and the very controlled nature of the populace.

Now, nothing that I have written in the first paragraph is in the least controversial. This way of looking at Singapore is basically the common stereotype of the nation itself, in the eyes of the rest of the developed world. However, today I met with a very surprising aspect of this tendency towards surveillance and control.

I was in a Polyclinic with one of my sons, when I noted a weighing machine. Now, not having weighed myself in a good six months (thus, not being particularly interested in it), I thought that I might as well see how I was faring. So, I stepped onto the rather oddly shaped weighing machine. I saw it was odd because it had a column stretching up into the air above me, in addition to the weighing panel below me.

I rather expected to see a digital readout of my weight at that point. Indeed, I thought it would give me my body mass index too (since that was advertised on the machine). However, it gave me something else, something really disturbing, in my view. It asked me to scan my NRIC (national identity) card. That really spooked me. You see this machine, sitting quietly on its own in a Polyclinic, was actually spying for the state of Singapore. This is because anyone who actually weighed themselves with it, would have to identify themselves first. The machine would then weigh them. The tall column above the person, had a sensor at the top which, presumably, measured their height. These two pieces of information would then be used to calculate the BMI - or body mass index. This index is a measure of whether or not someone is "obese" and therefore open to various disease risks.

The machine itself is a good idea - however, the manner in which it had been implemented in Singapore struck me as a very bad one. By requiring all who used to it, to prove their identity, the machine could be used to gather data on individuals in Singapore, which should be private, really. Why would the machine ask for ID? The only possible reason is that the information is being stored against the person's name. If the information were not being stored, it would be a waste of time to ask for ID. It would make no sense. Yet, it seems to me a basic breach of individual privacy, that someone could not measure their BMI, in a Singaporean Polyclinic, without simultaneously having that information recorded for the attention of persons unknown. It should be at the discretion of the individual whether or not that information is made known to the state. They should have the power to decide the limits of knowledge of the state about themselves. After all, the state does not OWN the individual...or does it? The answer to that, for all other countries that I am familiar with is "no" - but with Singapore, one is left to wonder. Why have a machine to determine BMI that takes away from people the right to determine who knows that information about them? Is that reasonable?

Today, is a special day, in a way. It marks the first time, in my life, that I have seen a piece of medical equipment that demands ID from a person before it can be used. It is the first time in my life, that I have seen a piece of medical equipment that seems to automatically gather data about the population at the individual level.

George Orwell, the writer of "1984", would have recognized the weighing machine as the kind of device that would be common in his envisioned world. His was a world of total surveillance, in which even the tv in people's homes was a spying device that looked out into the rooms of every home in the land. A weighing machine that gathers data about the people who use it, is the very same kind of device. The spirit of the machines is akin.

In my title I have enclosed medicine in inverted commas. There is a good reason for this. You see, to my mind, medicine is about serving the patient's needs: the patient is centre of the whole edifice and the doctor, the hospital and all its staff and resources are there to meet his or her medical needs. Yet, that odd weighing machine doesn't fit into such a schema. A weighing machine that gathers data automatically about the people who use it, seems to be serving a different master, than a medical one. It takes control of the medical experience away from the patient. It creates a situation of involuntary submission of personal information. It seems, in fact, to serve the needs of a state to monitor its people - in this case, most invasively. A machine that automatically monitors the BMI of the population that uses it, is a machine that did not get permission from the patient, for a record to be made. It is a machine that takes personal freedom away from the patient. It subverts the innocent quest for a measurement of one's own weight and turns it into an invasion of privacy. It makes of it, yet another instance of the interests of the state, being placed above those of the individual.

Anyway, I didn't weigh myself. I didn't identify myself to this robotic "policeman". I stepped off the machine WITHOUT my BMI. You see, I wasn't about to submit a record of what I regard as private information, into some state electronic archive, by proceeding to weigh myself. As far as I am concerned, my BMI is a private matter for my attention alone.

Thus, it can be seen that the advent of medical machines that automatically record information leads immediately to a sharp reduction in care. Some people will choose NOT to use the machines and not learn more about their health, if that information is going to be archived. They will lose out on personal medical knowledge, because they will be seeking to ensure that no strangers have access to that information.

People should have the choice whether their medical data is recorded in databases. If they don't, some people will just avoid medical "care".

This unorthodox weighing machine is a step in a dangerous direction. The philosophy behind it is one that disregards the wishes of the patient. It doesn't ask the patient how they feel or what they want. It takes freedom and choice away from the individual. Each step in this direction, should be resisted - for the ultimate destination of such steps, is the total loss of personal freedom, choice and liberty. The road on which this machine stands goes to a place in which the state owns the individual - and treats the individual as property to be used as it wishes. Is that a road that Singapore should be travelling upon?

I suggest this. Reprogram the weighing machines. Take out the requirement for personal ID - and let them be what they should be: machines providing a private service, to allow a person to make a private assessment of their own health parameters - without forcing them to divulge it to anyone who cares to know. That is what medical "care" should be about: the patient, not the state.

P.S: For those who doubt my account of the Weighing Machine that Spies...please try this link:

http://www.avamech.com/B1000EC.htm

The machine I saw was by Avamech...and was very like this one. Note that it automatically transmits data to a computer - and that it captures identity for "database integration".

Unsurprisingly, Avalanche Mechtronics (hence Avamech...) is a Singaporean company. Perhaps only a company imbued with a worldview like Singapore's would manufacture a machine that takes a basic right to privacy away from its users.

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