Ehealth, the USA Patriot Act and other hurdles: the black lining on the
silver cloud
Recent anti-terrorism legislation in particular has raised the need for
worldwide agreement on an ethical framework for ehealth to the level of
extreme urgency. Professor Eike-Henner Kluge, the former Director of Ethics
and Legal Affairs of the Canadian Medical Association, who wrote the
well-known handbook Ethics for health informatics professionals,*
warns of serious and far-reaching new threats to the medical-privacy rights
of individuals and, in this wake-up call, discusses the issues inherent in
ethical uses of healthcare ICT.
ABSTRACT
Ehealth promises to rationalise healthcare delivery through greater
accessibility, quality and efficiency. However, it also presents a series of
risks to patients’ health data that extend beyond merely technical issues
and include professional, legal and ethical problems.
Chief among these are threats to security and privacy posed by national
legislation designed to enhance the ability of intelligence agencies to
operate effectively; the absence of international standards and
certification for health-information and healthcare professionals; a
corresponding lack of international enforcement mechanisms; and, at a more
fundamental level, a failure to appreciate the unique nature of electronic
healthcare records in relation to the ethics of healthcare itself.
This paper explains the nature of these issues and relates them to the
raison d’ętre of ehealth. Special emphasis is focused on threats to security
and privacy posed by the USA Patriot Act.
Br J Healthcare Comput Info Manage 2006; 23(9): 16–23
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