Although surveillance has long been a feature of public health practice, there has been no systematic and comprehensive analysis that meaningfully relates the history of surveillance to current public health policy and practice. Drs. Bayer and Fairchild will address the broad question of how shifting understandings of privacy, confidentiality and individual rights - as reflected in constitutional, ethical, and social norms - have affected our understanding and acceptance of public health surveillance. Through historical and contemporary analysis, the project will shed light on the core ethical and policy challenges posed by surveillance and provide key information for advancing public policy discussions. Case studies with both state and federal components - including infectious disease reporting, vaccine, cancer and birth defect registries, and occupational health reporting - as well as study of the Model State Public Health Privacy Act - will contribute to the development of public policy that is sensitive to privacy and confidentiality and the demands of research and public health.

Ronald Bayer is a professor at the Mailman School of Public Health at Columbia University where he has taught for 12 years. Prior to coming to Columbia he was at the Hastings Center, a research institute devoted to the study of ethical issues in medicine and the life sciences. Bayer's research has examined ethical and policy issues in public health, focusing especially on AIDS, tuberculosis, illicit drugs, and tobacco. His articles on AIDS have appeared in the New England Journal of Medicine, JAMA, The Lancet, the American Journal of Public Health, and The Milbank Quarterly. His books include Private Acts, Social Consequences: AIDS and the Politics of Public Health (1989); AIDS in the Industrialized Democracies: Passions, Politics and Policies (1991, edited with David Kirp); Confronting Drug Policy: Illicit Drugs in a Free Society (1993, edited with Gerald Oppenheimer); Blood Feuds: Blood, AIDS and the Politics of Medical Disaster (1999, edited with Eric Feldman); and AIDS Doctors: Voices from the Epidemic, written with Gerald Oppenheimer, published in July, 2000. In 1995 the National Institute of Mental Health recognized Bayer's work when he was awarded a 5-year Senior Scientist Award.