In this article, I use “Disclosure Winter” to describe conditions under which a population, or a subpopulation, does not disclose important negative, difficult, or corrective information — often for good reason, given prior experience with how that information has been used — while the resulting record continues to appear complete and healthy. Here I want to make that idea more concrete. IIf Disclosure Winter names the system-level problem of what happens when difficult information stops...

What that sentence promised — and what’s actually happening to it There’s a sentence nearly every clinician has said, in some form, thousands of times: your information is confidential, and it’s used for your care. For most of the history of this profession, that sentence was simply true. The record stayed in the chart. The chart stayed in the clinic. Confidentiality had edges you could point to, and consent described something both people in the room understood. This post is about what’s...

The brief argues that this linked, longitudinal object may no longer be adequately governed as an anonymised case. It proposes calling it a Digital Subject Representation (DSR) and suggests that it may warrant a dedicated governance category — one that treats it more like a research subject record than a de-identified dataset.