Ethics in Biomedical and Health Informatics: Users, Standards, and Outcomes

book cover: "Biomedical Informatics: Computer Applications in Health Care"

Ethics in Biomedical and Health Informatics: Users, Standards, and…

“More and more the tendency is towards the use of mechanical aids to diagnosis; nevertheless, the five senses of the doctor do still, and must always, play the preponderating part in the examination of the sick patient. Careful observation can never be replaced by the tests of the laboratory. The good physician now or in the future will never be a diagnostic robot.”

-Scottish surgeon Sir William Arbuthnot-Lane ( Lane 1936 )

This quote opens Chapter 10 of the book Biomedical Informatics: Computer Applications in Health Care and Biomedicine. The Chapter titled “Ethics in Biomedical and Health Informatics: Users, Standards, and Outcomes” was written by Kenneth W. Goodman, Reid Cushman, and Randolph A. Miller.  Read the Chapter

10.6 Summary and Conclusions [2014 edition]

Ethical issues are important in biomedical informatics, and especially so in the clinical arena. An initial ensemble of guiding principles, or ethical criteria, has emerged to orient decision making:

1. Specially trained human beings remain, so far, best able to provide health care for other human beings. Hence, computer software should not be allowed to overrule a human decision.
2. Practitioners who use informatics tools should be clinically qualifi ed and adequately trained in using the software products.
3. The tools themselves should be carefully evaluated and validated.
4. Health informatics tools and applications should be evaluated not only in terms of performance, including efficacy, but also in terms of their influences on institutions, institutional cultures, and workplace social forces.
5. Ethical obligations should extend to system developers, maintainers, and supervisors as well as to clinician users.
6. Education programs and security measures should be considered essential for protecting confidentiality and privacy while improving appropriate access to personal patient information.
7. Adequate oversight should be maintained to optimize the ethical use of electronic patient information for scientific and institutional research.

New sciences and technologies always raise interesting and important ethical issues. Much the same is true for legal issues, although in the absence of precedent or legislation any legal analysis will remain vague. Similarly, important challenges confront people who are trying to determine the appropriate role for government in regulating health care software. The lack of clear public policy for such software underscores the importance of ethical insight and education as the exciting new tools of biomedical and health informatics become more common.


Goodman KW, Miller RA. Ethics in biomedical and health informatics: Users, standards, and outcomes. In Shortliffe, EH, Cimino JJ, Chiang MF, eds., Biomedical Informatics: Computer Applications in Health Care and Biomedicine, Fifth Edition. Cham, Switzerland: Springer Nature, 2021, pp. 391-423. (Revised from the Fourth Edition, 2014.)