ADVANCED PATIENT RECORDS - SOME ETHICAL AND LEGAL CONSIDERATIONS TOUCHING MEDICAL INFORMATION SPACE

The application of advanced computer-based information technology to p atient records presents an opportunity for expanding the informational resource base that is available to health-care providers at all level s. Consequently, it has the potential for fundamentally restructuring the ethics of the physician/patient relationship and the ethos of cont emporary health-care delivery. At the same time, the technology raises several important ethical problems. This paper explores some of these implications. It suggests that the fundamental ethical issue at stake in these developments is the status of the electronic record which fu nctions as the analog of the health-care consumer in health-care decis ion making. Matters such as control and patient dignity are implicated . Other important ethical issues requiring solution include data owner ship, data liability, informed consent to use and retrieval, security and access. The paper suggests that the ethical problems that arise ca nnot be solved in piecemeal fashion and on a purely national basis. Th ey should be addressed in a coordinated international fashion and rece ive appropriate legal expression in the relevant countries and be inco rporated into appropriate codes of ethics.