Original Paper

Ethics and Information Technology

, Volume 13, Issue 4, pp 355-363

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Ethics in e-trust and e-trustworthiness: the case of direct computer-patient interfaces

  • Philip J. NickelAffiliated withDepartment of Philosophy and Ethics, School of Innovation Sciences, Eindhoven University of Technology Email author 


In this paper, I examine the ethics of e-trust and e-trustworthiness in the context of health care, looking at direct computer-patient interfaces (DCPIs), information systems that provide medical information, diagnosis, advice, consenting and/or treatment directly to patients without clinicians as intermediaries. Designers, manufacturers and deployers of such systems have an ethical obligation to provide evidence of their trustworthiness to users. My argument for this claim is based on evidentialism about trust and trustworthiness: the idea that trust should be based on sound evidence of trustworthiness. Evidence of trustworthiness is a broader notion than one might suppose, including not just information about the risks and performance of the system, but also interactional and context-based information. I suggest some sources of evidence in this broader sense that make it plausible that designers, manufacturers and deployers of DCPIs can provide evidence to users that is cognitively simple, easy to communicate, yet rationally connected with actual trustworthiness.


Direct computer-patient interfaces e-trust e-trustworthiness e-health Ethics of biomedical engineering Evidentialism Health care ethics Obligations of designers Trust Trustworthiness