Ethical issues and the electronic health record

Ethical issues (beneficence, autonomy, fidelity, and justice) related to electronic health records (EHRs) confront health personnel, health leaders, and health policy makers. EHRs are seen as beneficent because of alleged increased access to health care, but research has not consistently demonstrated access for disadvantaged persons. Autonomy is jeopardized when patients' health data are shared or linked without the patients' knowledge. Fidelity is breached by the exposure of thousands of patients' health data through mistakes or theft. Lack of confidence in the security of health data may induce patients to conceal sensitive information, and as a consequence, patients’ treatment may be compromised. Justice is breached when persons, because of their socioeconomic class or age, do not have equal access to health information resources and public health services. Health personnel, leaders, and policy makers should discuss the ethical implications of EHRs before the occurrence of conflicts among the ethical principles. Recommendations to guide health personnel, leaders, and policy makers are provided.