Personal Identifiability in the Icelandic Health Sector Database

Personal identifiability is a fundamental question in the ongoing debate about the Icelandic Bill and Act on the Health Sector Database (HSD). If the data are personally identifiable, Iceland's international legal commitments indicate that a priori consent must be obtained from patients for the use of their personal medical information. The HSD Act presumes that oneway coding of personal identifiers renders the data non-personally identifiable and that therefore a priori consent is not required. The history of the debate on the HSD shows that the concept of personal identifiability was initially based on a notion of 'considerable amount of time and manpower' as a criterion for defining personal identifiability. This definition comes from Recommendation R(97)5 of the Committee of Ministers of the Council of Europe on Medical Data. As a result of the Icelandic Data Protection Commission's opinion on the HSD, that concept was rejected and the resulting Bill and HSD Act adopted a definition from the European Data Protection Directive (95/46). The rejected concept, however, reentered with the idea that one-way coding of personal identifiers means there is no key that can be used to trace the identity of a person in the database. The question of what constitutes a key in this context is of fundamental importance. The database will collect and link data from different sources on individuals over time and