Missed chances and wrong choices in patient information? An ethical evaluation of the Finnish implementation of the EU Database Directive

Abstract

Patient&nbsp; information&nbsp; is&nbsp; a&nbsp; critical&nbsp; instrument&nbsp; in&nbsp; modern&nbsp; healthcare.&nbsp; The&nbsp; different&nbsp; interest&nbsp; groups<br />involved in health care hold an interest for patient information. As the interests of these groups are<br />to&nbsp; a&nbsp; degree&nbsp; mutually&nbsp; exclusive,&nbsp; the de&nbsp; jure status&nbsp; of&nbsp; patient&nbsp; information&nbsp; is&nbsp; of&nbsp; vital&nbsp; importance.<br />Problematically,&nbsp; the&nbsp; Finnish&nbsp; legislation&nbsp; regulating&nbsp; patient&nbsp; information&nbsp; is,&nbsp; as&nbsp; this&nbsp; paper&nbsp; shows,<br />neither clear nor does it meet the demands of efficiency or ethicality.<br />As&nbsp; ethics&nbsp; hold&nbsp; a&nbsp; critical&nbsp; position&nbsp; in&nbsp; determining&nbsp; the&nbsp; justified&nbsp; owner&nbsp; of&nbsp; patient&nbsp; information,&nbsp; the<br />legislative solution to the different&nbsp; interests ought to&nbsp; be ethically well justified. This paper argues<br />that an ethically acceptable formulation of ownership, if passed into law, prevent the harmful effects<br />of unethical use of patient information.&nbsp; A strong philosophical understanding of patient information<br />is necessary to judge whether the legislative solution is reasonable or not.<br />This paper presents some arguments from Locke and Kant, which point&nbsp; out&nbsp; problems&nbsp; in directive<br />96/9/EC,&nbsp; the&nbsp; so-called&nbsp; database&nbsp; directive,&nbsp; and&nbsp; in&nbsp; particular&nbsp; its&nbsp; Finnish&nbsp; implementation as&nbsp; regards<br />patient information databases. This paper concludes that citizens should be the owners of their own<br />patient information, in the sense of datenherrschaft, to meet the demands of ethicality.