Biometric identity systems in healthcare governance

1. Introduction

Biometric identity systems in healthcare governance refer to the use of unique physical or behavioural characteristics of individuals to establish and verify their identities within healthcare institutions and medical information systems. These characteristics may include fingerprints, facial recognition, iris patterns, voice recognition and other biological identifiers.

Biometric technology is increasingly used in hospitals, health insurance programmes, digital health platforms and government healthcare schemes. It helps healthcare authorities verify patient identities, prevent fraudulent medical claims, maintain accurate medical records and improve the delivery of healthcare services.

In India, biometric identification has become particularly relevant through Aadhaar-based authentication and the Ayushman Bharat Digital Mission (ABDM). These initiatives aim to improve healthcare accessibility, digital identification and coordination between healthcare providers.

However, biometric identity systems also raise important legal and ethical concerns relating to privacy, data security, informed consent, discrimination and exclusion of vulnerable individuals. Therefore, effective healthcare governance requires a balance between technological efficiency and the protection of fundamental rights.

2. Meaning and functions of biometric identity systems

Biometric identity systems use unique human characteristics to identify or authenticate individuals.

Their major applications in healthcare include:

A. Patient identification

Hospitals use biometric authentication to identify patients and connect them with appropriate medical records.

This reduces the possibility of duplicate patient records and identity-related errors.

B. Healthcare service authentication

Biometric systems may be used to verify the identity of beneficiaries accessing government healthcare programmes.

C. Medical record management

Biometric identification can help healthcare institutions connect patients with their medical histories, laboratory reports and treatment records.

D. Health insurance verification

Biometric authentication may assist in verifying beneficiaries and reducing fraudulent healthcare claims.

E. Healthcare workforce management

Hospitals may use fingerprint or facial recognition systems for employee attendance, access control and institutional administration.

F. Digital health services

Biometric authentication can support identity verification in digital healthcare platforms, subject to applicable legal and privacy safeguards.

3. Legal framework governing biometric identity systems in India

India has several legal and regulatory frameworks governing biometric identification, personal information and healthcare data.

A. Aadhaar Act, 2016

The Aadhaar (Targeted Delivery of Financial and Other Subsidies, Benefits and Services) Act, 2016 establishes the legal framework for Aadhaar-based identification.

The Unique Identification Authority of India (UIDAI) is responsible for Aadhaar administration.

Important provisions include:

Section 3: Entitlement to obtain an Aadhaar number.

Section 7: Aadhaar authentication for specified subsidies, benefits and services funded from the Consolidated Fund of India.

Section 8: Authentication of Aadhaar numbers.

Section 29: Restrictions on sharing, displaying and using core biometric information.

Section 30: Biometric information treated as sensitive personal information for the purposes of the Act.

In healthcare, Aadhaar-based identification may be used in applicable government schemes, subject to statutory requirements and alternative identification arrangements where required.

B. Digital Personal Data Protection Act, 2023

The Digital Personal Data Protection Act, 2023 establishes a framework for processing digital personal data.

Biometric information linked or reasonably associated with an identifiable individual may constitute personal data under the Act.

Important compliance requirements include:

Providing appropriate privacy notices.

Establishing a lawful basis for processing personal data.

Implementing reasonable security safeguards.

Preventing unauthorised disclosure.

Complying with applicable data-retention and erasure requirements.

Providing mechanisms for exercising statutory data principal rights.

Healthcare institutions must consider these requirements when collecting and processing biometric information digitally.

C. Information Technology Act, 2000

The Information Technology Act provides legal protection against certain forms of unauthorised access, disclosure and misuse of electronic information.

Section 43 addresses specified unauthorised acts involving computer systems.

Section 66 provides penalties for computer-related offences committed dishonestly or fraudulently.

Section 72A addresses disclosure of personal information in breach of a lawful contract in specified circumstances.

These provisions may be relevant when healthcare institutions experience unauthorised access to biometric databases.

D. Clinical Establishments (Registration and Regulation) Act, 2010

The Clinical Establishments Act establishes a regulatory framework for registration and regulation of clinical establishments in states and union territories where it applies.

It supports the maintenance of appropriate standards in healthcare institutions.

E. Ayushman Bharat Digital Mission

The Ayushman Bharat Digital Mission (ABDM) was launched to develop India's digital healthcare infrastructure.

It promotes the creation and exchange of digital health records through mechanisms such as:

Ayushman Bharat Health Account (ABHA).

Healthcare Professional Registry.

Health Facility Registry.

Health information exchange systems.

ABHA is a digital health identifier and should not be confused with a mandatory biometric identity system. Its use is governed by the applicable ABDM framework and consent requirements.

4. International legal framework

A. General Data Protection Regulation (GDPR), 2016

The GDPR provides comprehensive protection for personal data within the European Union.

Article 4(14) defines biometric data as personal data resulting from specific technical processing relating to physical, physiological or behavioural characteristics that allow or confirm unique identification.

Article 9 classifies biometric data processed for uniquely identifying an individual as a special category of personal data.

Healthcare organisations must therefore satisfy the applicable conditions for processing such information.

B. UNESCO Universal Declaration on Bioethics and Human Rights, 2005

The declaration recognises the importance of human dignity, autonomy, privacy and confidentiality.

It provides ethical principles relevant to biometric identification in healthcare.

C. International Covenant on Civil and Political Rights, 1966

Article 17 protects individuals against arbitrary or unlawful interference with their privacy.

This principle is relevant to healthcare biometric systems because medical identity information requires appropriate legal and technical safeguards.

5. Major legal and ethical concerns

A. Privacy and confidentiality

Biometric information is highly personal because it is linked to an individual's physical or behavioural characteristics.

Unauthorised access may create long-term privacy risks.

Healthcare institutions must implement appropriate security safeguards and restrict access to authorised personnel.

B. Informed consent and individual autonomy

Patients should receive appropriate information about biometric collection, its purpose, use and relevant risks.

Where consent is the applicable legal basis, it must satisfy the requirements of the governing data protection framework.

C. Data breaches and cybersecurity

Healthcare databases may contain biometric identifiers alongside medical records, insurance information and personal details.

A cybersecurity breach may expose sensitive information and undermine public confidence.

D. Discrimination and exclusion

Biometric authentication may fail because of age-related changes, physical disabilities, injuries or technical limitations.

If healthcare services depend exclusively on biometric verification, vulnerable individuals may face difficulties accessing essential treatment.

Therefore, appropriate alternative authentication mechanisms are important.

E. Function creep

Information initially collected for healthcare identification may potentially be used for unrelated purposes.

Such secondary use raises questions concerning purpose limitation, proportionality and legal authorisation.

F. Accuracy and accountability

Incorrect biometric matching may result in patient identification errors, improper medical record allocation or denial of healthcare benefits.

Healthcare institutions must establish procedures for correcting errors and resolving identity disputes.

6. Important case laws

The following judicial decisions establish important principles concerning privacy, biometric identification, informed consent and healthcare governance.

A. Justice K.S. Puttaswamy v. Union of India (2017)

The Supreme Court of India recognised the right to privacy as a fundamental right under Article 21 and Part III of the Constitution.

The judgment recognised informational privacy, individual autonomy and protection against unjustified interference with personal information.

Significance: This decision provides the constitutional foundation for protecting biometric and medical information. Healthcare institutions must ensure that biometric collection and processing satisfy applicable requirements of legality, necessity and proportionality.

B. Justice K.S. Puttaswamy (Retd.) v. Union of India (2018)

The Supreme Court examined the constitutional validity of the Aadhaar framework.

The Court upheld the Aadhaar Act with important limitations and safeguards. It also restricted certain forms of mandatory private-sector use of Aadhaar authentication.

Significance: The judgment is particularly relevant to biometric healthcare identification because it establishes that Aadhaar authentication must operate within constitutional and statutory limits. Healthcare institutions cannot assume that biometric authentication is automatically compulsory in every medical service.

C. District Registrar and Collector v. Canara Bank (2005)

The Supreme Court examined privacy concerns relating to access to private financial records.

The judgment recognised the importance of protecting confidential information from unjustified interference.

Significance: Its broader privacy principles are relevant to healthcare biometric databases, where unauthorised access to personal identification and medical information may violate individual privacy.

D. Samira Kohli v. Dr. Prabha Manchanda (2008)

The Supreme Court considered the requirements of informed consent in medical treatment.

It held that consent must be based on adequate information about the nature and purpose of the proposed medical procedure.

Significance: This judgment supports the importance of patient autonomy when healthcare institutions collect biometric information as part of medical identification or treatment-related procedures.

E. Common Cause v. Union of India (2018)

The Supreme Court recognised the right to die with dignity and examined individual autonomy in medical decision-making.

The judgment reinforced the importance of dignity and personal choice in healthcare.

Significance: Its broader principles support patient autonomy and the protection of individual rights when biometric technologies are introduced into healthcare systems.

7. Responsibilities of healthcare institutions

Hospitals, laboratories, insurance providers and digital healthcare platforms must adopt responsible biometric governance practices.

Their major responsibilities include:

Lawful collection: Collect biometric information only when legally justified.

Purpose limitation: Use biometric information only for authorised purposes.

Data security: Apply encryption, access controls and appropriate cybersecurity safeguards.

Patient awareness: Explain the purpose and relevant implications of biometric authentication.

Alternative identification: Provide appropriate alternatives when biometric authentication fails.

Data minimisation: Avoid collecting unnecessary biometric information.

Access monitoring: Maintain appropriate records of access to biometric databases.

Incident management: Establish procedures for responding to data breaches.

Regulatory compliance: Follow applicable Aadhaar, data protection and healthcare requirements.

Accountability: Establish clear responsibility for misuse or unauthorised disclosure.

8. Challenges in implementing biometric healthcare systems

Despite their advantages, biometric identity systems face several implementation challenges in India.

Technical limitations: Fingerprint and facial recognition systems may produce inaccurate results because of environmental conditions, physical characteristics or equipment limitations.

Digital inequality: Rural populations and economically disadvantaged communities may have limited access to reliable digital infrastructure.

Cybersecurity threats: Centralised biometric databases may become attractive targets for cybercriminals.

Lack of awareness: Patients may not understand how their biometric information is collected, stored or shared.

Institutional coordination: Healthcare institutions, government agencies and technology providers may follow different data management practices.

Legal uncertainty: Rapid technological development creates new regulatory questions concerning artificial intelligence, biometric surveillance and secondary data use.

9. Conclusion

Biometric identity systems have become an important component of modern healthcare governance. They can improve patient identification, reduce administrative errors, strengthen healthcare authentication and support digital health services.

However, their use must remain consistent with constitutional rights, privacy protection, patient autonomy and data security requirements.

In India, the Aadhaar Act, 2016, Digital Personal Data Protection Act, 2023, Information Technology Act, 2000 and Ayushman Bharat Digital Mission framework provide important elements of the applicable regulatory structure.

Judicial decisions such as Justice K.S. Puttaswamy v. Union of India, Puttaswamy v. Union of India (Aadhaar judgment) and Samira Kohli v. Dr. Prabha Manchanda establish significant principles concerning privacy, biometric identification and informed consent.

Ultimately, effective biometric healthcare governance requires transparency, proportionality, strong cybersecurity, alternative identification arrangements and respect for individual rights. Biometric technology should improve healthcare accessibility rather than become a barrier to essential medical services.