Cyberspatial privacy in the digital age: a proxemics-based framework with a healthcare application

The rapid digitalization of healthcare-from telemedicine and Artificial Intelligence (AI)-driven diagnostics to wearable biosensors-has profoundly disrupted traditional norms of patient confidentiality. Classical privacy theories, anchored in physical co-presence and individual control, struggle to address the ethical challenges posed by opaque, persistent, and infrastructural data exposures in digital clinical environments.

This study employs a theoretical-conceptual methodology to develop a multidimensional privacy framework responsive to the spatial and technological complexities of the digital clinic. Drawing from Edward T. Hall's proxemics theory and the concept of cyberspace, we reinterpret interpersonal spatial zones (intimate, personal, social, public) in cyberspace. We introduce "cyberspatial privacy" as a transversal dimension that modulates privacy expectations across physical and digital layers. A hypothetical case-"Patient X," a woman undergoing hybrid care-is used to demonstrate the framework's practical utility in ethical analysis.

The proposed framework reconceptualizes privacy as a dynamic continuum structured by both spatial proximity and digital mediation. By mapping risks across four proxemic zones and overlaying a cyberspatial dimension, the model reveals how privacy breaches differ not only in kind but in normative weight. For instance, biometric data collected by wearables (intimate zone) carries higher ethical risk than metadata exposed via public interfaces. The case of Patient X illustrates how classical theories fail to capture this gradient, while the new model enables zone-sensitive assessments of vulnerability, exposure, and trust.

This framework advances the ethical understanding of privacy in digitally mediated healthcare by offering a granular, relational, and context-aware approach. It supports clinicians, designers, and policymakers in tailoring privacy safeguards to the spatial and digital contours of care. By reframing privacy as a condition of relational co-presence rather than isolated consent, this model promotes ethically robust design and governance in the era of cyber-augmented medicine.