Study Set Content:
Evidence from () is preferable to evidence from uncontrolled retrospective studies, and verification by independent investigators is required before the most recent reports are put into common practice. 18 Ethics, Standards, and Scientific Progress
randomized controlled trials
➢ People who develop, maintain, and sell health care computing systems and components have obligations that parallel those of
system users
Holding patient care as the
leading value
(first do no harm) applies to developers as well as to practitioners
The Hippocratic injunction primum non nocere
➢ Role of (blank) as a MORAL CRITERION
NTENTION
ace trust and advocacy; Such a stance cannot be maintained if goals and intentions other than patient well-being are assigned primacy
Professional-patient relationship
As with health care systems and the people producing these systems, there should be trust throughout the system and
maintenance
System purchasers, users, and patients must trust developers and maintainers to recognize the potentially grave consequences of errors or carelessness, trust them to care about the uses to which the systems will be put, and trust them to value the reduced suffering of other people at least as much as they value their own ()
personal gain.
() should stimulate scientific progress and innovation while safeguarding against system error and abuse
Quality standards
is needed to maximize the accuracy of inferential engines, it is trivially clear how such a standard will help to prevent decisionsupport mistakes
database accuracy
the standard should be seen to foster
progress and innovation
cientific and technical standards are perfectly able to stimulate progress while taking a cautious or even conservative stance toward permissible risk in patient care
“progressive caution”
Any move toward “()” in health informatics is shallow and feckless if it does not include a way to measure whether a system performs as intended
best practices
Ten criteria for system scrutiny
1. Does the system work as designed?
2. Is it used as anticipated?
3. Does it produce the desired results?
4. Does it work better than the procedures it replaced
5. Is it cost effective?
6. How well have individuals been trained to use it?
7. What are the anticipated long-term effects on how departments interact?
8. What are the long-term effects on the delivery of medical care?
9. Will the system have an impact on control in the organization?
10. To what extent do effects depend on practice setting?
One challenge involves balancing two competing values
free access to information, and 2. protection of patients’ PRIVACY and CONFIDENTIALITY
are necessary for people to mature as individuals, to form relationships, and to serve as functioning members of society.
Privacy and confidentiality
generally applies to people, including their desire not to suffer eavesdropping, whereas () is best applied to information.
Privacy, confidentiality
In discussions of the electronic health care record, the term privacy may also refer to individuals’ desire to restrict the disclosure of personal data
National Research Council, 1997
are widely regarded as rights of all people, and such protections help to accord them respect
privacy and confidentiality
are entitlements that a person does not need to earn, to argue for, or to defend
…privacy and confidentiality a
