The National Security Agency (NSA) has a paper on a ‘security enhanced Linux’ it has developed which vividly shows the free and open source software process in action. Could it be useful in medicine? From the paper: ‘…This version of Linux has a strong, flexible mandatory access control architecture incorporated into the major subsystems of the kernel. The system provides a mechanism to enforce the separation of information based on confidentiality and integrity requirements. This allows threats of tampering and bypassing of application security mechanisms to be addressed and enables the confinement of damage that can be caused by malicious or flawed applications…the integration of these security research results into Linux may encourage additional operating system security research that may lead to additional improvement in system security…