Petraeus affair and the role of biographers

NEW YORK (AP) — The affair between retired Army Gen. David Petraeus and author Paula Broadwell is but an extreme example of the love/hate history between biographers and their subjects.

Even before their outing led to Petraeus' resignation as CIA director, Broadwell had been criticized for the rosy tone of "All In," which The Associated Press described in 2011 as "part hagiography and part defense" of his strategy in Iraq and Afghanistan. But as long as biographies are written by and about human beings, scientific precision will remain an ideal. The stories of famous women and men often are colored by rapture and disenchantment, confusion and bias.

"As with psychiatrists, same with biographers, you shouldn't sleep with your subject," Blake Bailey, the prize-winning biographer of authors John Cheever and Richard Yates, said with a laugh.

"The ideal case is to have no assumptions. ... But it is possible to write a great book and have strong opinions. ('Eminent Victorians' author) Lytton Strachey, the father of all modern biographers, had a very distinctive voice and a very distinctive perspective — a person looking down from the world at a great distance, quite disparagingly, but with vast humor that informs every word."

Broadwell conducted extensive interviews with both critics and supporters of Petraeus, but the finished story was overwhelmingly positive. She is far from alone in allowing personal or professional regard to shape a biography, especially when the subject cooperates. Flattering books come out all the time, whether a biography of Dick Cheney by Weekly Standard writer Stephen Hayes or Chris Matthews' "Jack Kennedy: Elusive Hero."

Years spent together, as Broadwell had with Petraeus in Afghanistan, can make the biographer's experience intensely personal, whether sexual or not. Walter Isaacson did not avoid the unpleasant side of Steve Jobs, but acknowledged he had bonded strongly with the dying Apple CEO. Doris Kearns Goodwin was an aide to Lyndon Johnson who sometimes took notes while the ex-president lay in her bed, a relationship that she called platonic and described in her book on him, "Lyndon Johnson and the American Dream."

Some relationships end in court. Jimmy McDonough spent years working on an authorized biography of Neil Young, only to have Young withdraw support and attempt to stop publication, leading to mutual lawsuits and delay in the release of "Shakey," which came out in 2002. Some biographers seem energized by perceived sins, like the late Albert Goldman and his takedowns of Elvis Presley and John Lennon. Others use scholarship to build up or pick apart a figure from the distant past. Jon Meacham's new biography of Thomas Jefferson praises him as a subtle and effective politician, while a competing book, Henry Wiencek's "Master of the Mountain," faults Jefferson as a calculating slave holder who tolerated brutality.

David McCullough has likened the biographer's choice to picking a roommate, one you must live with for years. McCullough himself abandoned a Picasso book out of distaste for the painter's private life and chose men he related to for his two Pulitzer Prize winning presidential biographies, Harry Truman and John Adams. Former JFK aide Arthur M. Schlesinger Jr. won a Pulitzer for "A Thousand Days," his book on the Kennedy administration. But his reverence for the late president led Gore Vidal to dismiss "A Thousand Days" as a "political novel."

Biography often is the art of reconciling opposites. Robert Caro, the prize-winning biographer of New York municipal builder Robert Moses and Lyndon Johnson, has taken on men who have both inspired and dismayed him. A former investigative journalist, Caro sees his job as collecting as much information as possible and only then forming opinions. There is no such thing as "objective truth," he says, but there are enough "objective facts" to bring you close.

For his Moses and Johnson books, Caro has relied upon countless documents and interviews. He has labeled his Johnson series, begun soon after the president's death and still going, as a narrative of darkness and light, of the basest cruelty and the noblest achievement. His Moses book, "The Power Broker," was another epic of greatness and destruction and even more complicated to write because he actually interviewed Moses.

"You were awed by seeing the scope of his vision as he talked about it to you and explained it to you. You see him standing in front of this map, with a yellow pencil and sharp point, just gesturing toward this tri-state area that he sees as one entity and has a vision for it," says Caro, whose book was harshly criticized by Moses, but won the Pulitzer in 1975 and is now standard reading.

"But I was simultaneously talking to the people he had displaced, hounded them out of their homes. You have to show both of these things, his genius and its effect on people."

Authors have followed paths they never imagined before starting a book or encountering the subject. Edmund Morris was a prize-winning biographer of Theodore Roosevelt, but the chance to write about a living president led him to take unusual license. Granted years of access to Ronald Reagan, Morris was left so mystified that he inserted a fictionalized version of himself into the book, "Dutch," as a way of making sense out of the president.

Jane Leavy, author of a well-regarded biography on Mickey Mantle, said she had a hard time starting the book because of her childhood worship for the New York Yankees star. She decided the best way to move ahead was to acknowledge up front her memories, and map out the life of the flawed and troubled man she came to know and to hear about.

"He was multidimensional and far more complicated than the hagiographic biographies I read in school or the dark stories about him being a womanizer and an offensive drunk," she says. "No one is one way or another. The fact he was horrible to his wife doesn't invalidate his skill. So the task became why he treated people the way he did. And that's the biographer's job."

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Drug Compounders Get Help on Capitol Hill





WASHINGTON — Despite two decades of dire health warnings and threats of federal intervention, the specialty drugmakers at the center of the nation’s deadly meningitis outbreak have repeatedly staved off tougher federal oversight with the help of powerful allies in Congress.




Over the years, industry friends like Tom DeLay, the former House Republican leader from Texas, have come to its defense. Even Senator Edward M. Kennedy, regarded as the strongest health care advocate in Congress in recent times, dropped efforts to impose new safeguards.


But the pharmacists known as compounders are now facing their biggest regulatory threat as they confront questions on Wednesday and Thursday at Congressional hearings on the deadly outbreak. The question is whether Congress will move to oversee the niche industry more aggressively.


“A lot of the blame for the meningitis situation lies at Congress’s door,” said Larry D. Sasich, a research pharmacist who has written about compounders’ safety record. For specially mixed drugs that fall into a gray area of federal law, he said, “the protections for your cat or dog are stronger than for your wife and children.”


By Washington standards, the industry’s financial clout is not terribly large. The main trade group, the International Academy of Compounding Pharmacists, has spent $1.1 million on lobbying in the past decade, while major players in the business have given at least $300,000 to candidates since 2008, according to data from the Center for Responsive Politics, a research group in Washington.


But by positioning itself as a more affordable, community-based alternative to huge drug manufacturers, compounders have attracted broad support from politicians. They have become popular among proponents of hormone therapy to slow aging and advocates for the autistic, who often distrust the traditional pharmaceutical industry, and rely on compounders’ tailor-made blends.


If history is a guide, it often takes a disaster to get real change in the law.


In 1938, Congress passed the Food, Drug and Cosmetic Act after a drug company mixed an antibiotic with a toxic solvent and more than 100 people were killed, many of them children. In 1962, it amended that act to effectively create the modern drug approval system after thalidomide, a German drug intended to treat morning sickness in pregnant women, caused severe birth defects in Europe, said Kevin Outterson, an associate professor of law at Boston University.


Experts say the magnitude of the current crisis, in which more than 400 people have been sickened with meningitis and 32 have died, may finally spur action. This week’s hearings are expected to include testimony from the head of the Food and Drug Administration and the head of the Massachusetts pharmacy that produced the tainted drug.


Much of the scrutiny has focused on lax oversight by state boards and the Food and Drug Administration. But public health and drug industry experts say Congress is partly to blame for failing to clearly define the F.D.A.’s authority to police the practice.


A familiar cycle has played out in Washington since the 1990s: Publicity over illnesses or deaths from compounding drugs prompts outrage. Expert witnesses warn of the dangers of an unregulated industry. Proposals to fix the system follow. Then nothing happens.


“The public is at risk, an alarming great risk,” one pharmacist warned in 2003 Senate testimony after one person died and five more fell ill from contaminated medicine in 2002 produced by a South Carolina pharmacy.


Compounding, the practice of mixing medicines for individual patients, has grown in recent decades, helping fill gaps during drug shortages and offering cheaper versions of commercial drugs. But it has also become prone to abuse, with some pharmacies becoming, in effect, mini-drug manufacturers.


While the F.D.A. has clear authority to regulate drug manufacturers, state authorities have the main jurisdiction over pharmacies. Determining which category a company falls into is difficult because compounders are not required to give the F.D.A. access to their books.


Ultimately, stronger regulation has been stymied by sharp opposition from the industry and its defenders in Congress, both Democrats and Republicans, many of whom have compounders in their districts.


In 2008, the F.D.A. challenged what it said were misleading claims by compounders that their hormone therapy for older women was safer and more natural than that of big drug makers; it was met with staunch opposition, including objections from Suzanne Somers, the celebrity anti-aging advocate. The agency eventually prevailed.


Hundreds of members of Congress have attended conferences or taken part in charitable events and letter-writing campaigns organized by the International Academy of Compounding Pharmacists. The trade group said recently that its Congressional supporters had surged in recent years and that compounding had “gone from being a little-known practice to having a strong and steady presence in Washington.”


Texas, home to many compounding pharmacies and their main trade lobbying group, has been an important base of support, producing industry allies like Mr. DeLay and Representative Joe L. Barton, a Texas Republican.


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Toyota Prius recall: Automaker will fix nearly 700,000 hybrids









Toyota Motor Corp. announced two safety recalls for its flagship Prius hybrid.

The automaker said the steering intermediate extension shafts in 670,000 Prius cars sold in the U.S. need to be inspected and in some cases replaced. And 350,000 of those hybrids also will have to have their electric water pumps replaced.

Toyota will recall another 2 million vehicles worldwide, including the Prius and the Corolla, to fix the same problems.  





The gas-sipping Prius has become an important vehicle for Toyota, giving the company a reputation for producing fuel-efficient, green vehicles and quietly becoming one of the best sellers in the automaker’s lineup.

Toyota is on track to sell more than 250,000 Prius hatchbacks and station wagons this year, which will make it one of the best selling passenger cars in the U.S.  So far this year, the Prius has been the best selling car in California. Toyota sells more hybrids in the U.S. than all other automakers combined.

In the U.S., the recall includes 2004 through 2009 model year Prius hybrids.

The steering shaft problem results from a manufacturing error in which certain parts in the system did not have the required hardness and can deform.

Toyota said that in some of the cars, the electric motor that drives the water pump that circulates coolant through the hybrid components can shut off. In some cases this can cause the hybrid system to stop while the vehicle is being driven.
 
There have been no crashes or injuries reported for these two conditions.

Owners of vehicles covered by these safety recalls will receive an owner notification letter via first-class mail starting in December.  Any authorized Toyota dealer will perform these recalls at no charge.

This is the second large recall by Toyota in barely a month.  

In October, the Japanese automaker recalled 2.5 million vehicles nationally to fix a faulty power window switch that has been linked to at least nine injuries and several hundred reports of smoke and fire. In one instance reported to federal regulators, a passenger in a Camry was burned while trying to use a loose article of clothing to extinguish a fire caused by the switch.

The big recalls come as Toyota's vehicle sales in the U.S. have been surging after being derailed last year. Sales were hurt by manufacturing disruptions and inventory shortages caused by the Japanese earthquake. Massive recalls in 2010 for sudden-acceleration problems and other safety defects also added to Toyota's sales woes.

ALSO:

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Honda rushes Civic redesign

Electric cars don't pencil out

Follow me on Twitter (@LATimesJerry), Facebook and Google+.





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Mike D'Antoni plans to coach Lakers on Sunday













Mike D'Antoni


Mike D'Antoni won NBA coach of the year in his first full season as head coach of the Phoenix Suns.
(Jeff Gross / Getty Images)































































Just finished interviewing new Lakers Coach Mike D’Antoni by telephone, and how’s that for a fine start in town — he's talking to Page 2.

It’s going to take a little while to transcribe tape and write a column, but here’s how we began Tuesday morning.

"Got bad news for you, Mike. You’re losing 73% to 11% to Phil Jackson in a poll of who people would like to see coaching the Lakers."





D’Antoni laughs. "I’ve got some really close friends who are Laker fans and they were disappointed I got the job."

Reminded that the fans in Staples Center have been chanting, "We want Phil," D’Antoni says, "They can’t chant, 'We want Mike,' because they got him."

D’Antoni is still recovering from reconstructive surgery on his right knee. He’s getting around now with one crutch or a cane.

He will fly to Los Angeles on Wednesday, meet his team Thursday and says he’s probably aiming to make his Lakers coaching debut Sunday.

"When I feel better I’ll start coaching, and I think miraculously I’ll start feeling better when Steve [Nash] is feeling better," he says. "I’ve already tried coaching without him and that didn’t work out too well, so I’m thinking I’ll be smart this time."

If the tape recorder batteries hold up, more to come soon.

ALSO:

Phil Jackson gets call from Lakers and it's not what he expected

Lakers players surprised but enthused by hiring of Mike D'Antoni

It's unanimous: Lakers' selection of Mike D'Antoni over Phil Jackson is wrong






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Day-Lewis heeded inner ear to find Lincoln's voice

LOS ANGELES (AP) — A towering figure such as Abraham Lincoln, who stood 6 feet 4 and was one of history's master orators, must have had a booming voice to match, right? Not in Daniel Day-Lewis' interpretation.

Day-Lewis, who plays the 16th president in Steven Spielberg's epic film biography "Lincoln," which goes into wide release this weekend, settled on a higher, softer voice, saying it's more true to descriptions of how the man actually spoke.

"There are numerous accounts, contemporary accounts, of his speaking voice. They tend to imply that it was fairly high, in a high register, which I believe allowed him to reach greater numbers of people when he was speaking publicly," Day-Lewis said in an interview. "Because the higher registers tend to reach farther than the lower tones, so that would have been useful to him."

"Lincoln" is just the fifth film in the last 15 years for Day-Lewis, a two-time Academy Award winner for best actor ("My Left Foot" and "There Will Be Blood"). Much of his pickiness stems from a need to understand characters intimately enough to feel that he's actually living out their experiences.

The soft, reedy voice of his Lincoln grew out of that preparation.

"I don't separate vocal work, and I don't dismember a character into its component parts and then kind of bolt it all together, and off you go," Day-Lewis said. "I tend to try and allow things to happen slowly, over a long period of time. As I feel I'm growing into a sense of that life, if I'm lucky, I begin to hear a voice.

"And I don't mean in a supernatural sense. I begin to hear the sound of a voice, and if I like the sound of that, I live with that for a while in my mind's ear, whatever one might call it, my inner ear, and then I set about trying to reproduce that."

Lincoln himself likely learned to use his voice to his advantage depending on the situation, Day-Lewis said.

"He was a supreme politician. I've no doubt in my mind that when you think of all the influences in his life, from his childhood in Kentucky and Indiana and a good part of his younger life in southern Illinois, that the sounds of all those regions would have come together in him somehow.

"And I feel that he probably learned how to play with his voice in public and use it in certain ways in certain places and in certain other ways in other places. Especially in the manner in which he expressed himself. I think, I've no doubt that he was conscious enough of his image."

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Q & A: Weighing the Evidence





Q. My husband weighs twice as much as I do, yet we take the same dose of over-the-counter medications, as recommended on the packaging. Shouldn’t weight be a factor?




A. There is little information about using weight as a factor in adjusting doses of either prescription or over-the-counter medications, said Dr. Steven A. Kaplan, director of the Iris Cantor Men’s Health Center at NewYork-Presbyterian/Weill Cornell hospital.


“We are beginning to study different responses by weight,” he said, but he and other researchers have reached no conclusions on recommendations for therapy.


“In my own field, urology,” he added, “my opinion is that it is more likely for the recommended dose to be ineffective in a larger person rather than to be toxic in a thinner adult.”


Some prescription drugs, like chemotherapy agents, already have their dosages adjusted for weight because of their highly toxic nature. As for over-the-counter drugs, recommended doses generally tend to be weighted in favor of safety rather than efficacy, Dr. Kaplan said.


He and other doctors emphasized the importance of following package directions. For example, acetaminophen (like Tylenol) can present a life-threatening risk if the liver cannot process a high dose. If you find that the recommended dose does not work for you, Dr. Kaplan said, speak to your doctor.


C. CLAIBORNE RAY


Readers may submit questions by mail to Question, Science Times, The New York Times, 620 Eighth Avenue, New York, N.Y. 10018, or by e-mail to question@nytimes.com.



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Bank of New York Mellon unit settles Madoff case for $210 million













New York Atty. Gen. Eric Schneiderman


New York Atty. Gen. Eric Schneiderman
(Carolyn Kaster / Associated Press)






























































A Bank of New York Mellon subsidiary will pay $210 million to settle claims it concealed red flags showing  Bernard Madoff was a fraud.

Due diligence by the unit, Ivy Asset Management, revealed discrepancies in Madoff's stated investment strategy, according to a statement by New York Atty. Gen. Eric Schneiderman, who announced the settlement Tuesday.

While Ivy steered clients to invest in Madoff, collecting fees for itself, some at the firm had reservations about Madoff, the attorney general said.





Schneiderman cited an email one Ivy principal sent to a subordinate: "Ah, Madoff, you omitted one possibility - he’s a fraud!"

Ivy didn't disclose its suspicions to clients, Schneiderman said, and falsely told them that "we have no reason to believe there is anything improper in the Madoff operation."

 “Ivy Asset Management violated its fundamental responsibility as an investment advisor by putting its own pecuniary interests ahead of the interests of its clients," Schneiderman said. "An investment advisor should apprise its clients of risks, but Ivy deliberately concealed negative facts it uncovered in its due diligence of Madoff in order to keep earning millions of dollars in fees. As a result, its clients suffered massive and avoidable losses."

Madoff's massive multibillion-dollar Ponzi scheme was revealed in December 2008. He has been serving a 150-year prison sentence.

Schneiderman sued Ivy in 2010. The settlement concludes suits also brought by the U.S. Department of Labor and private plaintiffs, and includes another $9 million from other defendants. The settlement will repay Madoff's investors and cover fees and expenses of those who brought the suits.

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Mike D'Antoni to be next coach of the Lakers









Mike D'Antoni, not Phil Jackson, will be the next coach of the Lakers.

"We signed Mike D'Antoni to a multi-year deal," Lakers spokesman John Black said, mentioning the team's owner and top two executives. "Dr. [Jerry] Buss, Jim Buss and Mitch Kupchak were unanimous that Mike D'Antoni was the best coach for the team at this time."

D'Antoni, 61, coached the New York Knicks last season and the Phoenix Suns before that. He will officially take over the Lakers within a week or two, depending how quickly he recovers from knee-replacement surgery.





The Lakers will introduce their new coach at a news conference as early as Tuesday but more likely later in the week. Bernie Bickerstaff will remain the team's interim coach for now.

D'Antoni signed a three-year deal for $12 million. The team holds an option for a fourth year.

Jackson was the overwhelming favorite to return to the Lakers until they heard his informal demands, which included a stake in team ownership, according to a person familiar with the situation.

"He was asking for the moon," said the person, who also declined to be identified because they are not authorized to discuss the situation.

The Lakers then moved quickly to sign D'Antoni. He replaces Mike Brown, who was fired Friday after the Lakers began the season 1-4, their worst start since 1993.

Earlier Sunday, Lakers guard Steve Nash said it would "be a coup" for the Lakers to bring back Jackson, but he also had kind words for D'Antoni.

"Obviously, I think everyone knows how much I love Mike," said Nash, who played four seasons and won two MVP awards under D'Antoni in Phoenix. "If he were the coach, it would be seamless and terrific for me, and I think the team as well.”

D’Antoni was most recently employed by the Knicks, when he was forced to resign under pressure last season after an 18-24 start.

Kobe Bryant did not hide his excitement for the prospect of Jackson returning but, like Nash, he was also on board with D'Antoni.

"They know how I feel about Phil. They know how I feel about D'Antoni," Bryant said Sunday. "I like them both."

D'Antoni's coaching staff with the Lakers likely will start with two longtime assistants -- his brother, Dan D'Antoni, and Phil Weber.

The new Lakers coach has a 388-339 coaching record in the NBA. He led the Suns to the Western Conference finals in 2005 and 2006 with Nash running the show.

Bryant became familiar as a boy with D'Antoni, who was a star in the Italian league in the 1980s, when Bryant's father also played in Italy. D'Antoni helped Olimpia Milano win five league titles and two European club titles. D'Antoni also worked with Bryant on the U.S. national team as an assistant.

ALSO:

Photos: Lakers Coach Mike D'Antoni

Lakers, Steve Nash playing waiting game

Interim Coach Bernie Bickerstaff tries to keep it simple





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Elmo puppeteer accused of underage relationship

NEW YORK (AP) — The puppeteer who performs as Elmo on "Sesame Street" is taking a leave of absence from the popular kids' show in the wake of allegations that he had a relationship with a 16-year-old boy.

Sesame Workshop said puppeteer Kevin Clash denies the charges, which were first made in June by the alleged partner, who by then was 23.

"We took the allegation very seriously and took immediate action," Sesame Workshop said in a statement issued Monday. "We met with the accuser twice and had repeated communications with him. We met with Kevin, who denied the accusation."

The organization described the relationship as personal and "unrelated to the workplace." Its investigation found the allegation of underage conduct to be unsubstantiated. But it said Clash exercised "poor judgment" and was disciplined for violating company policy regarding Internet usage. It offered no details.

"I had a relationship with (the accuser)," Clash told TMZ. "It was between two consenting adults and I am deeply saddened that he is trying to make it into something it was not."

At his request, Clash has been granted a leave of absence in order to "protect his reputation," Sesame Workshop said.

No further explanation was provided, nor was the duration of his leave specified.

"Elmo is bigger than any one person and will continue to be an integral part of 'Sesame Street' to engage, educate and inspire children around the world, as it has for 40 years," Sesame Workshop said in its statement.

"Sesame Street" is currently in production, but other puppeteers are prepared to fill in for Clash during his absence, according to a person close to the show who spoke on condition of anonymity because that person was not authorized to publicly discuss details about the show's production.

"Elmo will still be a part of the shows being produced," that person said.

The 52-year-old Clash, the divorced father of a grown daughter, has been a puppeteer for "Sesame Street" since 1984. It was then that he was handed the fuzzy red puppet named Elmo and asked to come up with a voice for him. Clash transformed the character, which had been a marginal member of the Muppets troupe for a number of years, into a major star rivaling Big Bird as the face of "Sesame Street."

In 2006, Clash published an autobiography, "My Life as a Furry Red Monster," and was the subject of the 2011 documentary "Being Elmo: A Puppeteer's Journey."

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Slipstream: Biometric Data-Gathering Sets Off a Privacy Debate





“PLEASE put your hand on the scanner,” a receptionist at a doctor’s office at New York University Langone Medical Center said to me recently, pointing to a small plastic device on the counter between us. “I need to take a palm scan for your file.”




I balked.


As a reporter who has been covering the growing business of data collection, I know the potential drawbacks — like customer profiling — of giving out my personal details. But the idea of submitting to an infrared scan at a medical center that would take a copy of the unique vein patterns in my palm seemed fraught.


The receptionist said it was for my own good. The medical center, she said, had recently instituted a biometric patient identification system to protect against identity theft.


I reluctantly stuck my hand on the machine. If I demurred, I thought, perhaps I’d be denied medical care.


Next, the receptionist said she needed to take my photo. After the palm scan, that seemed like data-collection overkill. Then an office manager appeared and explained that the scans and pictures were optional. Alas, my palm was already in the system.


No longer the province of security services and science-fiction films, biometric technology is on the march. Facebook uses facial-recognition software so its members can automatically put name tags on friends when they upload their photos. Apple uses voice recognition to power Siri. Some theme parks take digital fingerprints to help recognize season pass holders. Now some hospitals and school districts are using palm vein pattern recognition to identify and efficiently manage their patients or students — in effect, turning your palm into an E-ZPass.


But consumer advocates say that enterprises are increasingly employing biometric data to improve convenience — and that members of the public are paying for that convenience with their privacy.


Fingerprints, facial dimensions and vein patterns are unique, consumer advocates say, and should be treated as carefully as genetic samples. So collecting such information for expediency, they say, could increase the risks of serious identity theft. Yet companies and institutions that compile such data often fail to adequately explain the risks to consumers, they say.


“Let’s say someone makes a fake ID and goes in and has their photo and their palm print taken as you. What are you going to do when you go in?” said Pam Dixon, the executive director of the World Privacy Forum, an advocacy group in San Diego. “Hospitals that are doing this are leaping over profound security issues that they are actually introducing into their systems.”


THE N.Y.U. medical center started researching biometric systems a few years ago in an effort to address several problems, said Kathryn McClellan, its vice president who is in charge of implementing its new electronic health records system. More than a million people in the New York area have the same or similar names, she said, creating a risk that medical personnel might pull up the wrong health record for a patient. Another issue, she said, was that some patients had multiple records from being treated at different affiliates; N.Y.U. wanted an efficient way to consolidate them.


Last year, the medical center adopted photography and palm-scan technology so that each patient would have two unique identifying features. Now, Ms. McClellan said, each arriving patient has his or her palm scanned, allowing the system to automatically pull up the correct file.


“It’s a patient safety initiative,” Ms. McClellan said. “We felt like the value to the patient was huge.”


N.Y.U.’s system, called PatientSecure and marketed by HT Systems of Tampa, has already scanned more than 250,000 patients. In the United States, over five million patients have had the scans, said Charles Yanak, a spokesman for Fujitsu Frontech North America, a division of Fujitsu, the Japanese company that developed the vein palm identification technology.


Yet, unless patients at N.Y.U. seem uncomfortable with the process, Ms. McClellan said, medical registration staff members don’t inform them that they can opt out of photos and scans.


“We don’t have formal consent,” Ms. McClellan said in a phone interview last Tuesday.


That raises red flags for privacy advocates. “If they are not informing patients it is optional,” said Joel Reidenberg, a professor at Fordham University Law School with an expertise in data privacy, “then effectively it is coerced consent.”


He noted that N.Y.U. medical center has had recent incidents in which computers or USB drives containing unencrypted patient data have been lost or stolen, suggesting that the center’s collection of biometric data might increase patients’ risk of identity theft.


Ms. McClellan responded that there was little chance of identity theft because the palm scan system turned the vein measurements into encrypted strings of binary numbers and stored them on an N.Y.U. server that is separate from the one with patients’ health records. Even if there were a breach, she added, the data would be useless to hackers because a unique key is needed to decode the number strings. As for patients’ photos, she said, they are attached to their medical records.


Still, Arthur Caplan, the director of the division of medical ethics at the N.Y.U. center, recommended that hospitals do a better job of explaining biometric ID systems to patients. He himself recently had an appointment at the N.Y.U. center, he recounted, and didn’t learn that the palm scan was optional until he hesitated and asked questions.


“It gave me pause,” Dr. Caplan said. “It would be useful to put up a sign saying ‘We are going to take biometric information which will help us track you through the system. If you don’t want to do this, please see’ ” an office manager.


Other institutions that use PatientSecure, however, have instituted opt-in programs for patients.


At the Duke University Health System, patients receive brochures explaining their options, said Eliana Owens, the health system’s director of patient revenue. The center also trains staff members at registration desks to read patients a script about the opt-in process for the palm scans, she said. (Duke does not take patients’ photos.)


“They say: ‘The enrollment is optional. If you choose not to participate, we will continue to ask you for your photo ID on subsequent visits,’ ” Ms. Owens said.


Consent or not, some leading identity experts see little value in palm scans for patients right now. If medical centers are going to use patients’ biometric data for their own institutional convenience, they argue, the centers should also enhance patient privacy — by, say, permitting lower-echelon medical personnel to look at a person’s medical record only if that patient is present and approves access by having a palm scanned.


Otherwise, “you are enabling another level of danger,” said Joseph Atick, a pioneer in biometric identity systems who consults for governments, “instead of using the technology to enable another level of privacy.”


At my request, N.Y.U. medical center has deleted my palm print.


E-mail: slipstream@nytimes.com.



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