Ethical issues in the use of electronic health records for pharmacy medicines sales

摘要

Purpose – Pharmacy sales of over-the-counter medicines in the UK represent an economically significant and important mechanism by which customers self-medicate. Sales are supervised in pharmacies, but this paper seeks to question whether patients' electronic health records (EHRs) – due to be introduced nationally – could be used, ethically, by pharmacists to ensure safe medicines sales. Design/methodology/approach – Using theoretical arguments, three areas of ethical concern are identified and explored in relation to pharmacists' access to EHRs-consequentialsim, analogies and confidentiality/privacy. Findings – Consequentialist arguments include positive benefits to customer's welfare and control of medicine of abuse, but negative economic healthcare burdens and consequences due to potentially increased or paradoxically, decreased presentation of patients to doctors. Socially accepted analogous practices – credit checks, existing pharmacy access to information and hospital treatment – are then argued to be ethically relevant and supportive of access. Privacy and confidentiality are then considered as reasons not to allow EHR access. A contrasting view is that pharmacy access to EHRs is another form of surveillance and hence the question of pharmacists' assess to EHRs may be answered negatively by empirical research that locates pharmacy customers as expert users and identifies confidentiality and privacy concerns about information technology in healthcare more generally. Originality/value – This paper offers a unique and valuable contribution to the debate about healthcare professionals' role-based access to patients' medical records and offers a reflection on the ethical concerns surrounding patient information and the rival concerns of patient qua customer autonomy and safety.