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Ethics in Archives



I am going to run the risk of repeating myself too often on this subject. In regards to medical records, I don't think it is good to use the same value judgments on them as on records in, say, a historical society.  Too often, I think it is assumed (on this list and elsewhere in the archival world) that all archives follow the old paradigm we learned in grad school of a place where outside researchers come in and use records for historical research.  Since confidential records can't be opened up to the public entirely and right now, they are useless, and why should we spend money keeping them?  

Perhaps the importance of the information in them should be placed on an equal footing with their availability to the public?

I don't know what institution you are working in, so I don't know what kind of medical records you have, but usually, they are extremely valuable for research.  General medical/scientific research can be carried out, eliminating names and other personal information but using long series of patient records to to come to conclusions about any number of medical or epidemiologic trends.  The longer the series, the better the information is.  If the older records are thrown out, the clock has to start ticking all over again for such projects (but nothing can really replace the information for that particular period).   Also, for people who suspect they have a hereditary ailment, medical-genealogical research is the ONLY way this can be established, and it can make a huge difference in the medical care of an entire family.  This type of research is getting to be ever more necessary as we move into a new era of medicine.  If the records are thrown away this obviously won't happen.  Uses such as this which were not much thought of a few years ago make it probable that we will see more new uses of these records which nobody is thnking of right now, either.  

Although I am not the medical records librarian here (we have a whole, huge department, much larger than the archives, which specializes in that, as do many medical institutions), I can say that we keep every medical record permanently.  After all, the medical record is really the quintessential record of the institution's work.  All the historical things, financial records, series used for writing social history, etc. are just the icing on the cake.  Of course, yours may be a non-medical institution (I notice "state" in the email address), and then it wouldn't be the same, but here, the medical record is the heart of what we are and do and have been, and none are ever destroyed.  They are also permanently confidential, and in order to see them, the petitioner has to have the permission of the estate or heir.    

As for other types of confidential records you mention, I am no expert.  We are concerned about the families of the people in the records as well, although if one is within legal requirements, the archivist's judgment comes into play, since there can be a big difference between, for example, records of nearly a century ago (not as many families still around) and recent items.

Sorry to get up on the soapbox again, but  think we often fall into a rut when thinking about "archives" - there are so many different situations that don't fit the traditional pattern, and I think we need to be careful about just following the "usual" approach to appraisal, as well as other aspects of the profession.  

Maybe if you are a state institution, the other government archivists would have a better handle than I do on how they approach these records.  Also, I realize the volume in an archives like that would make some hard decisions necessary on account of funding.

Fred Lautzenheiser
Cleveland Clinic Foundation

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