I will attempt to answer this question using the ethical framework governing the research on human subjects to see if it may apply to this situation (source of framework: Emanuel EJ, Wendler D, Grady C. What makes clinical research ethical? JAMA. 2000;283:2701-11. [PMID: 10819955]).
Here is the list of 7 framework requirements and their applicability to CDSS development as assessed by me –
- Social or scientific value: Benefits from CDSS should justify the resources spent and risks imposed on patients whose data has been used
- Scientific validity: Predictive decision-making methodology used by CDSS should be properly structured to meet its objectives
- Fair participant selection: Participant data should be selected to achieve a fair distribution of the burdens and benefits of CDSS.
- Favorable risk-benefit ratio: CDSS should be designed to ensure that the risks to an individual human participant are balanced by expected benefits to the same participant
- Respect for participants: Privacy of participant should be protected and confidentiality of their data should be maintained. This can be achieved by using de-identified data and obtaining patient consent for collection, use, and sharing of data
- Informed consent: Participant consent to include data in development of CDSS must be obtained. The risk to participant should be measured relative to risk associated with receiving care without use of CDSS. This risk should be communicated to the participant when obtaining informed consent.
- Independent review: CDSS development should receive independent ethical review that is appropriate to the level of potential risk it poses to participants.