Professionalism in the age of computerised medical records

Electronic medical records have the potential to improve clinical care and to provide answers to important research questions. Research using existing medical records has provided important knowledge about the effectiveness and risks of widely-used medications. However, electronic medical records also raise ethical dilemmas regarding informed consent and confidentiality. Breaches of confidentiality with electronic records can be more severe than breaches with paper records. Furthermore, computerised health information raises new ethical dilemmas regarding direct advertisements of new drugs to patients, the impact of email on the doctor-patient relationship and the quality of outsourced radiology readings. Resolving these dilemmas may require new regulations and laws. In the interim, society will need to rely on physicians' professionalism to minimise the risks of electronic medical records and to ensure that the benefits outweigh the risks.