In the nursing field there are alot of ethical issues that happen and ethical decisions have to be made. Studies show that in many respects, care has improved with use of technologies and when EHRs are fully achieved and experienced by nurses, they are much more likely to be satisfied with the EHR. Evidence is mounting that these systems are resulting in unintended consequences with patients safety implications, potentially contributing to provider moral distress. Nancy, a nurse, had a patient that was on the EHRs and the CDS  alert for sepsis because they scored high on the hospital sepsis screening built within the EHRs. The CDS alerts the physician to fluid  resuscitate. Then the EHRs indicate that the patient had been admitted before for heart failure, which when the physician comes in to pump more fluids in the patient Nancy is concerned because the EHRs reads the patient had HF. The physician has to then still follow the protocol with the sepsis alert. So now both doctors are concerned about what to do because the EHRs are reading a lot of different problems. That one ethical problem deals with EHRs triggering protocols that capture electronic quality measures, often tied to value-based purchasing payer models upon which the organization will be penalized in the event measures are not met. Four ethical issues: lack of supervisory support, fear of reprisal, hierarchical decision making, and silent nurses. Nancy questioned the physician’s  decision to follow the sepsis quality metric and not write in order in the EHR for slow intravenous fluid administration.  She verbally reports this information to the receiving ICU nurse and hopes for the best. With nurses familiar with the EHR they may be less familiar with the ethical issues due to the electronic information. Many nurses go against their morals sometimes due to that. 

Cited: https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Identifying-and-Addressing-Ethical-Issues-EHR.html