Series Preface | p. v |
Preface | p. vii |
Acknowledgments | p. xi |
Introduction: Case Studies in Ethics and Health Informatics | p. 1 |
The Business of Cyber Health Care | p. 9 |
Case Studies | p. 14 |
Health Services Online | p. 14 |
Shopping on the Web for Surgical Options | p. 14 |
Let the Buyer Beware | p. 15 |
Virtual Doctors | p. 16 |
Online Doctor Visits | p. 16 |
Litigious Patients | p. 17 |
Virtual Health Care Systems | p. 18 |
Online Coverage for Uninsured Consumers | p. 19 |
Smart Cards | p. 19 |
An Electronic Soapbox | p. 20 |
Virtual House Calls | p. 21 |
Cyber Home Health Care | p. 21 |
The Virtual House Call | p. 21 |
Dial-Up Medicine | p. 22 |
Cybercare | p. 23 |
Avoiding Drug-Drug Interactions | p. 23 |
An Interactive Support Group for ALS | p. 24 |
Information and Support on the Internet | p. 25 |
Fear and Communication | p. 25 |
Sale of Body Parts | p. 26 |
Internet Bids for a Kidney | p. 26 |
Sperm Bank Advertisements on the Internet | p. 27 |
Models' Eggs for Sale | p. 27 |
Suicide on the Web | p. 28 |
Suicide Web Site | p. 28 |
Online Medical Records | p. 28 |
Secure Medical Records on the Internet | p. 28 |
Cyber File Cabinet | p. 29 |
Medical Records on the Internet | p. 29 |
Medical Records Online | p. 30 |
Doctor Posts Patient Files on the Net | p. 31 |
Pharmaceutical Products | p. 31 |
Drug Bazaar | p. 31 |
The Internet Diet Doctor | p. 32 |
Dispensing via the Internet | p. 33 |
Dying for Sex | p. 33 |
Internet Prescriptions | p. 34 |
Online Importation of Drugs to the United States | p. 35 |
Foreign Sales of Drugs on the Internet | p. 35 |
Online Auction for Pharmaceuticals | p. 36 |
Drug Database Sells Advertisements to Sponsors | p. 37 |
Mental Health Services | p. 37 |
Diagnosing Depression by Computer | p. 37 |
The Cybercouch | p. 38 |
Counseling on the Internet | p. 39 |
Cyberchondriasis | p. 39 |
Tingling Feet or MS? | p. 39 |
Munchausen Syndrome and Medical Record Hacking | p. 40 |
Munchausen Syndrome Online | p. 41 |
Contents Consumer Health Information: Let the Viewer | |
Beware (Caveat Viewor) | p. 47 |
Case Studies | p. 51 |
Inaccurate Information | p. 51 |
Inaccurate Medical Information on the Web--Childhood Diarrhea | p. 51 |
Cancer Information on the Internet | p. 51 |
Internet Advice on Home Management of Feverish Children | p. 52 |
Unverified Health Claims | p. 53 |
"Web Slippery with Snake Oil" | p. 53 |
The Growth of Unverified Health Claims | p. 53 |
Laetrile | p. 54 |
Fears of Aspartame | p. 55 |
Beware of Dangerous Medical Advice Online | p. 55 |
Conflicts of Interest | p. 56 |
Web Site Sponsorship | p. 56 |
Promoting Products and Services | p. 57 |
Listing for Sale? | p. 58 |
Headache Resources on the Internet | p. 58 |
Professional Associations and For-Profit Web Sites | p. 59 |
Privacy and Confidentiality | p. 63 |
Case Studies | p. 73 |
Breaches of Security | p. 73 |
Sex Doctor's Patient Files on the Web | p. 73 |
Medical Records Online at a University Medical Center | p. 74 |
Security Breach of a Hospital's Voice Mail System | p. 75 |
Access to an Electronic Medical Record | p. 75 |
Electronic Mental Health Records | p. 76 |
A Case of Mistaken Identity | p. 77 |
Confidential Medical Records on Used Computers | p. 77 |
E-mail Goes Astray | p. 78 |
Inappropriate Use of Health Information | p. 79 |
Inappropriate Access to a Celebrity's Medical Record | p. 79 |
Patients Told They Had AIDS | p. 80 |
Medical Records for Sale | p. 81 |
Medical Care Database Information for Sale | p. 82 |
Credit Card Fraud | p. 82 |
Banker Calls in Loans of Cancer Patients | p. 83 |
Misuse of Public Health Data | p. 83 |
Integrated Health Care Systems | p. 84 |
Patients' Files Used for Obscene Calls | p. 85 |
Abortion Clinic Sues CompuServe | p. 85 |
Men Contract Syphilis after Meeting in an Internet Chatroom | p. 86 |
Secondary Use of Medical Information | p. 86 |
Privacy of Pharmacy Data | p. 86 |
Tracking Consumers on the Web | p. 87 |
Release of Medical Information | p. 88 |
The Medical Insurance Bureau | p. 89 |
The Psychiatric Case Register | p. 90 |
Wellness Plan Files Used to Fight Employee Job-Related Injury Claims | p. 90 |
Dispute over Use of Medicaid Records | p. 91 |
Billing Data Released in Fraud Case | p. 92 |
Data Sharing | p. 93 |
Creating a National Database | p. 93 |
Medical Web Site Faulted on Privacy | p. 94 |
Privacy on Cancer Support Web Sites | p. 95 |
Violation of the Privacy of Pharmacy Customers | p. 96 |
Marketing Prescription Drugs | p. 96 |
Inappropiate Use of Patient Pharmacy Data | p. 97 |
Doctor Shaken to Find Personal Data on the Web | p. 98 |
Data Mining | p. 98 |
Rating Physicians | p. 99 |
Rating Physicians on Outcomes | p. 100 |
Physician Disciplinary Reports on the Internet | p. 100 |
The Wall of Silence | p. 101 |
AMA Fights for Control of Price Data | p. 101 |
Protection of Patients' Privacy | p. 102 |
Confidentiality of Patient Data | p. 102 |
Legislated Restrictions on Access to Medical Records for Research | p. 103 |
Hackers | p. 104 |
Beware: Hackers at Play | p. 104 |
Computer Engineer Sentenced | p. 104 |
University Tightens Computer Security | p. 105 |
Privacy Online | p. 105 |
Uncovering Physicians' Online Identities | p. 105 |
CEO Sues Online Critics | p. 106 |
The Challenge of Bioinformatics | p. 113 |
Case Studies | p. 117 |
Issues in Bioinformatics | p. 117 |
Computational Pharmacogenomics | p. 117 |
Genetic Information in Centralized Databases | p. 119 |
Computational Genomics and Intellectual Property | p. 120 |
Web-mediated Paternity Testing | p. 120 |
Errors in Genetic Databases | p. 121 |
Evaluation: An Imperative to Do No Harm | p. 123 |
Case Studies | p. 131 |
Failure of Health Information Systems | p. 131 |
A Troubled Hospital Medical Information System | p. 131 |
A Borrowed Pharmacy System | p. 132 |
Problems with a Billing and Payment System | p. 133 |
Physician Resistance to an Internet Based System | p. 134 |
Unanticipated Consequences of a Physician Order Entry System | p. 135 |
Automation of Inefficient Processes | p. 136 |
Failure of a "Best of Breed" Information System | p. 137 |
"No OSCAR" | p. 138 |
An Unsuccessful Computerized Medical Record System | p. 139 |
An Abandoned Computerized Medical Record System | p. 140 |
The Effects of Computerizing Medical Records on Clinic Function | p. 142 |
Electronic Prescriptions | p. 143 |
Programming Error Results in Overpayment of Doctors | p. 144 |
Information Systems That Harm Patients | p. 144 |
Malfunction of the Therac-25 | p. 144 |
Failure to Integrate Information Systems | p. 146 |
Concerns about the "Bedside Assistant" | p. 147 |
Online Challenges for Human Subjects Research | p. 154 |
Case Studies | p. 157 |
Clinical Trials | p. 157 |
Information Exchange as a Confounder | p. 157 |
Web Site with Patient Reports on HIV Treatment | p. 158 |
Promising Trial of New Drug Spurs Demand | p. 159 |
The Doctor-Patient Relationship | p. 159 |
Alternative Protocols for Cancer | p. 159 |
Patient-Doctor Conflict Over the Appropriateness of a Therapy | p. 160 |
Protocol Shopping on the Internet | p. 160 |
Research Ethics | p. 161 |
Mining Patient Records | p. 161 |
Snooping on Internet Chat Rooms | p. 162 |
Tracing Syphilis in Cyberspace | p. 162 |
Ethical Standards for Health Web Sites | p. 165 |
HON Code of Conduct (HONcode) for Medical and Health Web Sites | p. 166 |
eHealth Code of Ethics | p. 168 |
TRUSTe's Consumer Privacy Protection Guidelines | p. 176 |
TRUSTe Model Privacy Statement | p. 178 |
Health Internet Ethics: Ethical Principles For Offering Internet Health Services to Consumers | p. 184 |
Criteria for Assessing the Quality of Health Information on the Internet | p. 191 |
Principles Governing AMA Publications Web Sites | p. 199 |
Index | p. 211 |
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