Many hospitals use a clinical information system (CIS) to record and transmit patient data within the institution, in some cases in real time. Depending on the institution, the data is also shared with patients. CIS offer numerous advantages, such as increased efficiency, cost reduction, and greater transparency for patients. However, they also raise medical-ethical challenges. A position statement by the SAMS with recommendations for the responsible use of CIS is currently in preparation.
In the clinical information system (CIS), all internally available data—such as laboratory findings or diagnoses—are collected and made accessible to the healthcare professionals involved, and in some cases to the patients themselves. It is undisputed that patients must not be denied access to their own data. This access enables, among other things, active participation in clinical decision-making. However, the manner in which data and findings are communicated is of significant medical-ethical importance.
Communication and relationship: desired effects
The communication of diagnoses, findings, and treatment options should take place in a caring manner, particularly when the information is highly complex and/or has far-reaching implications. This is generally ensured within the context of a physician–patient consultation. Direct communication tailored to the specific circumstances is a central element of a trusting doctor–patient relationship. An undirected digital flow of information can undermine this relationship in the long term—especially when patients receive sensitive information directly from the CIS and are left to cope with it on their own. Since much of the information that healthcare professionals work with is preliminary in nature and may ultimately prove to be clinically irrelevant, unnecessary questions and anxieties may be triggered.
For patients with a high level of health literacy, the use of a CIS can represent a significant gain in autonomy. Shared decision-making in the doctor–patient consultations can be better supported when relevant information is already available in the CIS beforehand. Finally, the quality of documentation could also benefit from the attention with which patients read the entries in the CIS. In addition to improving workflow and interoperability, the use of a CIS can therefore have desirable effects in terms of medical ethics—provided that the systems are implemented in an appropriate manner. However, when adopting a CIS, it is also important to bear in mind that healthcare institutions may enter into a long-term relationship of dependency with the companies providing specific technical applications.
Position statement by the Central Ethics Committee of the SAMS
The Central Ethics Committee (CEC) of the SAMS appointed a working group in September 2025 and tasked it with preparing a position statement. The statement will examine and assess both the opportunities and the challenges associated with the use of clinical information systems and it will provide recommendations from a medical-ethical perspective for their responsible implementation. The position statement is expected to be published in winter 2026/2027.
Composition of the working group
Dr. sc. med. Valerie Luyckx, Zürich, Nephrology (Chair)
Dr. phil. Christian Budnik, SAMS, Bern (ex officio), Ethics
Dr. med. Markus Eichelberger, Bern, Internal Medicine
Dr. med. Antje Heise, Thun, Intensive Care Medicine
Dr. iur. Damian König, Sion, Law
Prof. Dr. med. Anja Lorch, Zürich, Oncology
Dr. med. Madeleine Mirabaud, Genève, Paediatrics
Prof. Dr. Settimio Monteverde, Zürich, Clinical Ethics
Bianca Schaffert-Witvliet, Schlieren, APN, Palliative Care
Dr. sc. med. Jan Schürmann, Basel, Clinical Ethics