Ethical and Legal Aspects of Medical Information Protection in Electronic Government

Abstract

Introduction: The digital transformation of healthcare systems has significantly enhanced the efficiency, accessibility, and continuity of medical services. Electronic governance and health information technologies enable faster access to medical records, improved coordination among institutions, and data-driven clinical decision-making. However, the rapid integration of digital tools into healthcare introduces substantial ethical and legal challenges related to safeguarding patients’ personal medical information. Ensuring confidentiality, informed consent, cybersecurity, and accountability has become essential for maintaining trust in electronic health systems. International regulations such as the General Data Protection Regulation (GDPR), the Health Insurance Portability and Accountability Act (HIPAA), and Convention 108, together with national legislative frameworks, require healthcare institutions to implement robust data protection standards. Methods: This study employs a document analysis and legal review methodology. International regulatory documents, including GDPR, HIPAA, OECD recommendations, and WHO guidelines, were examined to identify core principles of digital health data governance. Georgian legislation, particularly the Law on Personal Data Protection, the Law on Health Care, and the Law on Medical Practice, was analyzed to assess its alignment with international norms. In addition, ethical principles such as autonomy, justice, non-maleficence, transparency, and accountability were evaluated as guiding frameworks for medical data protection. The analysis also incorporates insights from global literature on digital health transformation during the COVID-19 pandemic, which served as a catalyst for accelerated digital adoption, remote consultations, and large-scale electronic data processing. Results: The findings highlight several critical issues associated with the electronic management of medical information. First, the risk of cyberattacks and data breaches remains high, given that medical information is among the most sensitive categories of personal data. Unauthorized access, system errors, and insufficient cybersecurity measures can lead to significant harm, including discrimination, psychological distress, and financial loss. Second, patients frequently lack adequate understanding of informed consent procedures. Complex legal documents and technical terminology make it difficult for individuals to grasp what data are collected, how they are processed, and who has access to them. This undermines autonomy and reduces trust in digital health systems. Third, disparities in digital literacy create additional barriers, particularly for older adults and persons with disabilities, limiting their ability to use electronic health services effectively. Fourth, the rapid digitization triggered by the COVID-19 pandemic improved service continuity but also exposed weaknesses in data protection practices, particularly in contexts with limited infrastructure. Fifth, despite the existence of legal frameworks, practical implementation gaps remain within healthcare institutions, including insufficient staff training and inconsistent application of information security protocols. Nevertheless, electronic governance offers substantial benefits, such as improved transparency, timely access to health information, enhanced coordination, and better allocation of medical resources. These advantages underscore the need for strengthened governance mechanisms rather than retreat from digital systems. Conclusion: Ensuring the secure and ethical management of medical information in digital healthcare requires a comprehensive approach. Strengthening the legal framework, improving cybersecurity infrastructure, simplifying informed consent procedures, and enhancing digital competencies among both patients and healthcare professionals are essential steps. International cooperation and harmonization with global standards play a crucial role in creating resilient systems capable of adapting to technological advancements. Ultimately, building trustworthy, transparent, and ethically grounded electronic health governance will not only protect patient privacy but also enhance the quality, equity, and reliability of healthcare services in the digital era.