ArticleEthical Issues and the Electronic Health RecordLayman, Elizabeth J. PhD, RHIA, CCS, FAHIMA Author Information Reprinted from Layman EJ. Ethical issues and the electronic health record. Health Care Manag. 2008;27(2):165-176. doi:10.1097/01.HCM.0000285044.19666.a8. Author Affiliations: Department of Health Services and Information Management, College of Allied Health Sciences, East Carolina University, Greenville, New North Carolina. Corresponding author: Elizabeth J. Layman, PhD, RHIA, CCS, FAHIMA, Department of Health Services and Information Management, College of Allied Health Sciences, East Carolina University, Health Sciences Bldg 4340D, 600 Moye Blvd, Greenville, NC 27834 ([email protected]). The Health Care Manager 39(4):p 150-161, 10/12 2020. | DOI: 10.1097/HCM.0000000000000302 Buy Metrics Abstract Ethical issues related to electronic health records (EHRs) confront health personnel. Electronic health records create conflict among several ethical principals. Electronic health records may represent beneficence because they are alleged to increase access to health care, improve the quality of care and health, and decrease costs. Research, however, has not consistently demonstrated access for disadvantaged persons, the accuracy of EHRs, their positive effects on productivity, nor decreased costs. Should beneficence be universally acknowledged, conflicts exist with other ethical principles. Autonomy is jeopardized when patients’ health data are shared or linked without the patients’ knowledge. Fidelity is breached by the exposure of thousands of patients’ health data through mistakes or theft. Lack of confidence in the security of health data may induce patients to conceal sensitive information. As a consequence, their treatment may be compromised. Justice is breached when persons, because of their socioeconomic class or age, do not have equal access to health information resources and public health services. Health personnel, leaders, and policy makers should discuss the ethical implications of EHRs before the occurrence of conflicts among the ethical principles. Recommendations to guide health personnel, leaders, and policy makers are provided. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.