Off the charts: Medical documentation and selective redaction in the age of transparency

Matthew William McCarthy, Diego Real de Asua, Ezra Gabbay, Joseph J. Fins

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


A growing demand for transparency in medicine has the potential to strain the doctor-patient relationship. While information can empower patients, unrestricted patient access to the electronic medical record may have unintended consequences. Medical documentation is often written in language that is inaccessible to people without medical training, and without guidance, patients have no way to interpret the constellation of acronyms, diagnoses, treatments, impressions, and arguments that appear throughout their own chart. Additionally, full transparency may not allow physicians the intellectual or clinical freedom they need to authentically express questions, problematic impressions, and concerns about the patient’s clinical and psychosocial issues. This article examines the ethical challenges of transparency in the digital era and suggests that selective redaction may serve as a means to maintain transparency, affirm physician’s discretion, and uphold the core values of the doctor-patient relationship amidst disruptive technological change.

Original languageEnglish (US)
Pages (from-to)118-129
Number of pages12
JournalPerspectives in Biology and Medicine
Issue number1
StatePublished - Dec 1 2018

ASJC Scopus subject areas

  • Issues, ethics and legal aspects
  • Health Policy
  • History and Philosophy of Science


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