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Findings: In philosophical analysis, we identified privacy, confidentiality, trust, dependence, and ancillary care obligations as potential considerations for EAM use.
Conclusions: Among rural Ugandans participating in a study of HIV antiretroviral adherence, privacy, confidentiality, trust, and dependence were identified as key ethical considerations for EAM use, while autonomy was less important.
Counseling aims at helping people to address emotional, educational, social, vocational, and health-related issues and to promote personal and interpersonal understanding, growth, and functioning in an atmosphere of privacy, confidentiality, trust, support, comfort, and respect, as facilitated by professional counselors (Gladding 2004; Sheppard 2004).
Confidentiality, trust, wait times and short doctor-patient consultations were emphasized as being insufficient for culturally specific communications and often translating into inadequate treatment and care.
The issues of confidentiality, trust and respect that arise with the creation of computerised forms and databases are particularly important to manage in a culturally appropriate way in Aboriginal and Torres Strait Islander communities.
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But of course it also carries risk, and confidentiality and trust are at the heart of the doctor-patient relationship.
Dr Tony Calland, of the British Medical Association, said: "The essential principle that runs throughout the recording of medical information is that of confidentiality and trust.
At play here is a choice between two conflicting ethical impulses, to send a murderer to jail or to respect confidentiality, the trust that a narrator puts in you to handle the story of his life.
"There must be confidentiality and trust, and the health visitor must spend time with women they think have depressive symptoms".
He said: "The relationship between doctor and patient is based on a foundation of confidentiality and trust.
Finally, governance refers to the exchange of innovation capital, emphasizing that legal frameworks should include definitions for confidentiality and trust as well as sanctions for conflicts and misuse of the innovation capital.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com