Ethical problems in health information systems

Objectives: To introduce term and concept of infoethics and to argue on its importance for health information systems. Methods: To argue about our viewpoint of the dominance of the human compone nt, which has been discussed at an IMIA working conference held in Helsinki , Finland (February 1998) devoted to the evaluation of health information s ystems. Results and conclusions. Any technology sets a relationship between human b eings and their environment, both physical and human. No technology can be seen as merely instrumental. This is especially relevant when dealing with large automatic information systems, developed to contribute to the managem ent and integration of large organizations, such as hospitals. In such a co ntext, the environment is mainly made up of humans. In evaluating such info rmation systems, human factors preside over merely technical factors. Even if satisfying the latter is mandatory, they are never really sufficient. A perfect hard- and software system can be an absolute failure in everyday us e. In any information system, the human factor is, of course, human-compute r interaction, which always occurs when one person interacts with the machi nery. However, in a simultaneous multi-user context, human-human interactio n is the main question to tackle. The evaluation of large information syste ms, such as those found in hospitals, is founded in the whole concept of in ter-human relationships which underlie the design and use of the system. In deed, such an information system predominately appears as a social system, with its psychological, sociological and ethical features.