No abstract available.
Confidentiality* ; Informatics*

This paper covered a variety of issues that fall under the general rubric of ethical considerations in clinical psychopharmacologic research. The topics of ethical of subject selection and confidentiality, medication-free research. informed consent for those humans exposed to psychotropic drug research, and possible conflicts of interest in medical researcher/pharmaceutical sponsor were reviewed. Beginning with a brief section on the justifications for engaging in research, this review indentified the codflicts that inevitably arise between society's need for reliable and valid research and our obligation to protect subjects. Also author reviewed the patient consent issues, including the essential elements of informed consent, populations requiring surrogate consent, and confidentiality requirements. The paper continued with a discussion of responsible research practices, including the medication-free research, and conflicts of relationship between researcher and sponsor. In spite of a number of ethical dilemmas in clinical trials, the willingness of the scientist to confront the ambiguities of ethical questions in the pursuit of scientific knowledge reveals a basic truth, that is, the ethical characteristics of the scientist who undertakes such a task. Although it would be impossible to assure the general population that all researchers are ethical, it is incumbent on us to educate future researchers and provide practical guidelines for maintaining the primary ethical values of the individual who performs research with humans.
Confidentiality ; Ethics* ; Humans ; Informed Consent

PURPOSE: Upward feedback is becoming more widely used in medical training as a means of quality control. Multiple biases exist, thus the accuracy of upward feedback is debatable. This study aims to identify factors that could influence upward feedback, especially in medical training. METHODS: A systematic review using a structured search strategy was performed. Thirty-five databases were searched. Results were reviewed and relevant abstracts were shortlisted. All studies in English, both medical and non-medical literature, were included. A simple pro-forma was used initially to identify the pertinent areas of upward feedback, so that a focused pro-forma could be designed for data extraction. RESULTS: A total of 204 articles were reviewed. Most studies on upward feedback bias were evaluative studies and only covered Kirkpatrick level 1-reaction. Most studies evaluated trainers or training, were used for formative purposes and presented quantitative data. Accountability and confidentiality were the most common overt biases, whereas method of feedback was the most commonly implied bias within articles. CONCLUSION: Although different types of bias do exist, upward feedback does have a role in evaluating medical training. Accountability and confidentiality were the most common biases. Further research is required to evaluate which types of bias are associated with specific survey characteristics and which are potentially modifiable.
Bias (Epidemiology) ; Confidentiality ; Quality Control ; Social Responsibility

CONTEXT: Evolution of the scope and context of privacy and confidentiality brought about by use of information and communications technology in healthcare.

OBJECTIVE: To review the legal, professional and ethical landscape of health information privacy in the Philippines.

METHODOLOGY: Systematic review of literature and policy frameworks.

RESULTS: Philippine laws jurisprudence recognize and protect privacy of health information as a general rule; impose upon individual practitioners and institutions the obligation to uphold such right; and may apply in both the traditional and eHealth milieu. There is no existing policy framework that addresses issues relating to [a] access to health information by non-health professionals, [b] use of health information for non-health purposes, and [c] rules relating to collection, storage and utilization of electronically-derived or -stored information. A privacy culture, on either the provider's or client's side, is also lacking in the country.

CONCLUSION: Technological developments have outpaced policy and practice. There is a need to unify the patchwork of regulations governing the privacy of health information; advocate for a privacy culture among professionals and patients alike; fortify the evidence base on patient and provider perceptions of privacy; and develop and improve standards and systems to promote health information privacy at the individual and institutional levels. 

With the establishment of the Republic Act No. 11036, more popularly known as the Mental Health Act, improvement in the mental, neurologic, and psychosocial health took a step forward in the Philippines. This law, which was signed on June 2018, gave specific provisions in different aspects of delivery of mental health services to Filipinos. This law proved very useful in the dilemma faced in the following case where a potential problem in confidentiality was encountered.
Mental Health Services ; Confidentiality ; Mental Health ; Philippines

With the development of high-throughput technologies, biomedical data has been increasing exponentially in an explosive manner. This brings enormous opportunities and challenges to biomedical researchers on how to effectively utilize big data. Big data is different from traditional data in many ways, described as 3Vs - volume, variety and velocity. From the perspective of biomedical research, here I introduced the characteristics of big data, such as its messiness, re-usage and openness. Focusing on microbiome research of meta-analysis, the author discussed the prospective principles in data collection, challenges of privacy protection in data management, and the scalable tools in data analysis with examples from real life.
Biomedical Research ; Confidentiality ; Data Collection ; methods ; Microbiota

PURPOSE: The purpose of this study is to examine the factors influencing the barriers faced by Korean nurses in addressing the patients' sexual health. METHODS: The subjects in this study were nurses working at hospitals in Seoul and Jeonju. The data for this study were collected between November 2008 and December 2008. The subjects were assured of anonymity and confidentiality. RESULTS: The barriers to addressing the patients' sexual health were moderate in the subjects. The nurses had moderate sexual knowledge and communication skills. In a stepwise regression analysis, the areas of work, communication skills, participation in sexual health training, and experience in Obstetrics and Gynecology accounted for 18.3% of the variance of the barrier for addressing the patients' sexual health. CONCLUSION: These findings emphasize the need for the development of a patient-centered sexual health-related curriculum for nurses, which has been briefly discussed in Korea. An educational program that improves the nurses' communication skills will be effective in reducing the barriers to addressing the patients' sexual health and will help the nurses become sexual health specialists.
Anonyms and Pseudonyms ; Confidentiality ; Curriculum ; Gynecology ; Korea ; Obstetrics ; Reproductive Health ; Specialization

The first half of this article deals with the concept of informed consent. There are three important elements in practice. First, the consent must be specific as to the proposed intervention. Second, sufficient information must be provided so that a patient can fully understand the matter. For the criterion of sufficiency, this article proposes what might be called as 'the hypothetical self-test' with which physicians can self-evaluate the sufficiency of the information that they provide to the patient. Third, the consent must be given in a fashion to meet the patients' intellectual capabilities. In case the patient is not intellectual enough incapable, the consent, which is still required, can be obtained from a substitute decision maker. This article also suggests patients to prepare advanced directives when they are still competent, so as to avoid having their family members be left with moral quandaries of making the life with moral quandaries of making the life-and-death decision. The second half of this article deals with medical confidentiality. Why should a physician keep the medical record confidential? First, if the physician fails to keep medical confidentiality, hardly can trust be built between physicians and patients. Second, once the trust breaks down, physicians would face difficulties in taking the patients' medical histories, which are crucial to the diagnosis of the patient, because the patients obviously are reluctant to give information in that setting. Third, each individual should have control over information about him/herself. This article concludes with cataloging seven circumstances in which medical confidentiality is excused. (237 words).
Cataloging ; Confidentiality* ; Diagnosis ; Humans ; Informed Consent* ; Medical Records

This study was conducted to investigate selection criteria of health information and utilization pattern of health information on the Web by the consumers. Data were collected through off-line and on-line surveys. The off-line survey was conducted with 64 white color office workers in seven companies. The on-line survey was conducted on JoongAng Ilbo 'Healthcare' and KIHASA 'Healthguide' Web sites and 216 participated in the survey. To compare the selection criteria of the consumers with that of health informatics experts, an e-mail survey was done with twenty-six health informatics experts. Selection criteria of health information rated by consumers were in order of accuracy of content, scope and depth of content, privacy and confidentiality, and readability. Experts ranked in order of accuracy of content, purpose of sites, scope and depth of content, and readability. Seventy eight percent of consumers used the Internet once a month to search health information, 60.4% visited health-related Web sites via Internet search. The majority (85%) visited 2-5 different Web sites when they searched for health information. Eighty three percent of consumers regarded the health information on Internet as reliable. Ninety percent of consumers said that the health information on Internet was useful. Consumers used the Internet 'to find disease-related information' (86.1%), 'to find information on exercise and nutrition' (77.9%), 'to get an on-line advice' (42.5%), and 'to buy products or medicine for health' (18.9%). The results of the present study suggested what the health informatics experts should consider when they provide health information on the Internet and what consumers demand when they filter quality health information.
Comprehension ; Confidentiality ; Electronic Mail ; Informatics ; Internet* ; Patient Selection* ; Privacy

OBJECTIVES: Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. METHODS: This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. RESULTS: The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. CONCLUSIONS: The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical staff.
Computer Security ; Confidentiality ; Humans ; Internet* ; Medical Staff ; Pliability ; Telemedicine