Electronic Health Records: Why Does Ethics Count?

Abstract

The development of electronic health records marked a fundamental change in the ethical and legal status of health records and in the relationship between the subjects of the records, the records themselves and health information and healthcare professionals—changes that are not fully captured by traditional privacy and confidentiality considerations. The chapter begins with a sketch of the nature of this evolution and places it into the epistemic framework of healthcare decision-making. It then outlines why EHRs are special, what the implications of this special status are both ethically and juridically, and what this means for professionals and institutions. An attempt is made to link these considerations to the development of secure e-health, which requires not only the interoperability of technical standards but also the harmonization of professional education, institutional protocols and of laws and regulations.