Most healthcare institutions have integrated the use of electronic health records (EHR) as part of their data management strategies. As a critical healthcare technology, the EHR systematically collects patient data and stores it using a digital format. As recent technology aimed at increasing efficiency in healthcare service, the EHR enables the sharing of patient information across various healthcare settings (Lee, 2017). EHR also entails population information, medical history, demographics, immunization statuses, radiology images, personal information, laboratory test results, vital signs, medication, billing, and allergy information. While advancing the system's efficiency, healthcare practitioners accurately and legibly modify files to reduce the risk of losing patient information (Gopichandran, Ganeshkumar, Dash, & Ramasamy, 2020). Healthcare providers can also promptly retrieve data through search engine programs within the EHR system. Health researchers also use anonymized data to collect data that is crucial to making evidence-based decisions on improving healthcare practice. Scholars argue through longitudinal and cross-sectional studies that EHR systems improve the quality of healthcare. Different state and national regulations dictate the required length of storage of a patient’s health record. Centralized databases such as the trusted notary archive (TNA) offer secure data from different EHR systems to increase EHR systems.
Moral Problems that EHR Technology creates
The two critical moral problems that the EHR technology creates include violation of privacy and lack of confidentiality of patient information, and security breaches into EHR systems. Many patients are increasingly concerned about their privacy when asked for information that can be retrieved and shared within healthcare institutions (Lee, 2017). EHR systems offer a chance for a lack of confidentiality because patients feel that they cannot prevent disclosure of personal information to others. As a moral problem, unauthorized users, unregulated surveillance, overriding patient decisions, and institutional interference violates the privacy and confidentiality rights of a patient. The second moral problem is the security breaches into EHR systems. Previous incidences have indicated that healthcare staff can compromise medical data by accessing patient social security numbers, addresses, names, and other personal details to sell to fraudsters (Gopichandran et al., 2020). Without proper encryption, such information poses a risk to patients who can be extorted, stalked, or threatened. Another security breach is the lack of reliable anti-virus software. It leads to the possibility of losing patient’s data, which comes at a costly price of increasing sufferance or even death.
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The proper Moral Guidelines for dealing with Privacy, Confidentiality, and Security Breaches in EHR Systems
Healthcare service regulators need to enforce stringent punitive measures against healthcare professionals and institutions that violate the privacy, confidentiality, and security rights of patients. The use of such data should fall into the decision of the patient. If the patient lacks mental capacity, they should have a designated person acting within legal and moral definitions of such contexts. Gaining the patient's consent increases their autonomy in controlling the amount of information they share without feeling coerced. EHR systems should be dey accept authorization from persons that have pre-established role-based privileges subject to frequent audits. Before the authorized practitioners take up these roles, they need to undergo a predetermined period of training on privacy concerns and the importance of honoring them. Each healthcare institution needs stringent privacy and security policies that secure patients' information and increase trust in electronic health records systems. It should be a collaborative effort for healthcare practitioners, federal regulators, and public health officials in making EHRs secure. Using two-factor authentication systems ensures that people do not act in selfish interests to compromise patients' security.
Comparing my Approach to what a Utilitarian might Say
A utilitarian believes that concepts such as privacy, confidentiality, and security are designed to be practical and useful rather than attractive (Rachels & Rachels, 2018). Hence, the protection of privacy from a practical view is valuable to the patient only if it leads to social gain. Hence, within itself, a utilitarian might say that privacy is a fictitious attempt to withdraw from society. If a person’s privacy will not lead to the greater good for other people, it is morally right to compromise such privacy and confidentiality (Rachels & Rachels, 2018). In particular, in cases where a patient’s medical history and treatment presented an outstanding milestone in healthcare provision, a utilitarian may say that such information needs to be shared within or even without the patient's consent. In such a case, patient information disclosure shall help cure chronic illnesses that have previously challenged healthcare practitioners. Another example is when a person has a highly contagious disease, yet the patient wants to reunite with the family without disclosing such information. The utilitarian might say that such a person loses the entitlement to privacy and confidentiality because withholding such information shall lead to massive fatality.
Comparing my Approach to what an Ethical Egoist would say
From an ethical egoist perspective, protecting the privacy, confidentiality, and security of HER systems is right because the protector is a moral agent who acts to pursue their self-interest (Rachels & Rachels, 2018). In the case of punishing unauthorized personnel accessing and distributing patient information while propagating their self-interest, an ethical egoist says that moral agents should not harm others when making moral deliberation. Hence, patients can withdraw consent to publish their medical information and consider how disclosing such information will help the community. Hence, ethical egoists agree to the setting of regulations to control behavior that leads to harm to the patients through violating their privacy, confidentiality, and security rights.
References
Gopichandran, V., Ganeshkumar, P., Dash, S., & Ramasamy, A. (2020). Ethical challenges of digital health technologies: Aadhaar, India. Bulletin of the World Health Organization , 98(4), 277. Retrieved from https://www.who.int/bulletin/volumes/98/4/19-237123/en/
Lee, L. M. (2017). Ethics and subsequent use of electronic health record data. Journal of biomedical informatics, 71, 143-146. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28578074/
Rachels. J & Rachels S. (2018). The Elements of Moral Philosophy McGraw-Hill Education. Retrieved from http://93.174.95.29/main/E1E9B1F05DE422C68048CAA5F86ACD2D
