The Ethical Status of
Electronic Patient Records:
A Patient-Centered Perspective
Patient records in general, and electronic patient records in particular, occupy a special place in health care decision-making. Operationally, this results from the fact that the data which constitute the records are the basis of the information that is used in health care decision-making about patients. 1Ethically, it results from the fact patient records function as patient-analogues in information- and decision-space.
One of the primary claims advanced at the very beginning of this study was that because of their distinct ontological status and because of the unique place they occupy in health care decision-making, electronic patient records should be treated in an ethically special way. Specifically, they should be treated according to ethical principles that are analogues of the very same principles that normally should govern our conduct towards persons in the real world.
While the special ontological status of electronic patient records was dealt with in some detail in the preceding chapters, the issue of ethical treatment received little consideration. The purpose of the present chapter is to remedy this lack. Its aim, therefore, is threefold: to show that the treatment of electronic patient records should indeed be subject to ethical principles rather than pragmatically derived rules of conduct; to show further why these ethical principles should be analogues of the principles that govern conduct towards persons; and, finally, to sketch what the application of these analogue principles might look like in actual terms. Insofar as it fulfils these tasks, the present chapter lays the foundation for