Medical database security plays an important role in the overall secur
ity of medical information systems and networks. This is both because
of the nature of this technology and its widespread use today. Databas
e security not only involves fundamental ethical principles, but also
essential prerequisites for effective medical care. The development of
appropriate secure medical database design and implementation methodo
logies is an important research problem in the area and a necessary pr
erequisite for the successful development of such systems. The general
framework and requirements for medical database security are given an
d a number of parameters of the secure medical database design and imp
lementation problem are presented and discussed in this paper. A secur
e medical database development methodology is also presented which cou
ld help overcome some of the problems currently encountered.