In Reply.—We welcome the opportunity to comment on Dr Kwasman's letter. The potential misuse of collected data, be it vital records or the product of clinical investigation, requires that safeguards be adopted in developing strategies for medical or social research. The standard method used on vital records is to disassociate information that is deemed to be relevant for identification purposes from that which is not necessary for this function. Both maternal and neonatal information can be gathered from birth certificates in this way without appearing on the personal document (Figure). Obstetric complications, Apgar scores, and demographic and socioeconomic data can thereby be collected without compromising confidentiality.
The more fundamental issue raised in Dr Kwasman's letter, however, deals with the very purpose of collecting vital statistics. Clearly, there is utility in registering vital events for personal documentation. Yet, the analysis of vital data has made important contributions to understanding and improving the