J Med Ethics 38:535-539 doi:10.1136/medethics-2011-100413
  • Clinical ethics
  • Paper

Ethical questions must be considered for electronic health records

  1. Craig Fry1
  1. 1Health Ethics & Policy, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
  2. 2History and Philosophy of Science, University of Melbourne, Parkville, Victoria, Australia
  3. 3Melbourne East General Practice Network, Melbourne, Victoria, Australia
  4. 4Department of General Practice, Monash University, Clayton, Victoria, Australia
  1. Correspondence to Dr Merle Spriggs, Health Ethics & Policy, Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; merle.spriggs{at}
  1. Contributors All authors made substantial intellectual contributions to this paper. All made a substantive contribution to the conception and design of the paper, drafting and revising and gave final approval to the version submitted here.

  • Received 4 December 2011
  • Revised 26 March 2012
  • Accepted 28 March 2012
  • Published Online First 9 May 2012


National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing.


  • Funding The Institute for a Broadband Enabled Society (IBES), University of Melbourne.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.