Table 1.

Summary of the ethical issues concerning cardiac report cards (adapted from Nast S, Richard SA, Martin DK. Ethical issues related to cardiac report cards. Can J Cardiol. Mar 1 2004;20(3):325–328.)

Ethical issue	Description
Quality	•Quality operationalizes the ethical principles of beneficence and non-maleficence
	•Report cards may improve quality of care through external pressure from an informed public
	•Report cards may impede improvements to quality by generating anger and defensiveness
Informed Consent	•Informed consent operationalizes the ethical principle of autonomy
	•To make health care decisions, patients need and want information about their medical options
	•Report cards have the potential to provide this information and thus facilitate informed consent
Equity	•Equity operationalizes the ethical principle of justice
	•Health equity between regions is an important consideration in publicly funded health systems
	•Report cards must address policy makers to affect regional inequities in health care
Legitimacy	•Legitimacy operationalizes the ethical principle of justice, in this case deliberative forms of democratic justice
	•Report card authors must ensure that report cards are and perceived to be legitimate
	•The legitimacy of report cards will depend on their ability to meet stakeholders' reasonable expectations