Iranian Journal of Medical Ethics and History of Medicine

Recent developments in the digital domain and its influence in the health sector have led to the development of digital health technologies. The development of these technologies in addition to the benefits such as lowering medical care costs and improving the quality of patient care, has introduced new ethical challenges into the field of medicine. In this study, 25 articles were identified on the ethical challenges in digital health technologies by using literature review. These articles were in areas of mobile health, electronic health records, telemedicine, electronic health, wearable and big data technologies. The ethical challenges found in the articles reviewed in the field of digital health include: the privacy challenges that are due to the creation of huge data sources in this type of technology, how to ensure access justice, challenges for determining the responsibilities of surgical and technical members in telemedicine technologies, changing the patient's role, challenges regarding data ownership and patient access to raw data, the challenge of balancing the privacy of patient information and data sharing in advancing the community's science and health big data, and guaranteed quality of provided health information. These surveys can be effective in identifying challenges and developing ethical guidelines before developing and applying these types of technologies.

Good and healthy communication between physician and patient is cornerstone of a complete medical care that has long been considered in sociology. From the classical point of view, the physician-patient relationship as a unique relationship encompasses a wide range of cultural and social influences. Electronic health record not only has facilitated the treatment and diagnosis process, but also has promoted the health care system by organizing patient records; however, it alters the physician-patient relationship process culturally and it will create new ethical challenges. Based on current findings and analyses Opinions of health experts about the cultural and communication dimensions of this technology, the electronic health record, despite its effectiveness, easy and convenient diagnosis, awareness of other physicians' diagnosis, earlier and better treatment, has cultural obstacles such as security, reduction of emotional and face-to-face actions, and fear of social stigma. Having a suitable cultural context and information and awareness can affect development of health technology. The results of this study, which have identified the role of culture on physician-patient relationships in context of using electronic health record, shows that building trust in patients and changing cultural conditions through education and improving system security can increase the efficiency of this system in health care processes.