## 6 Ethical Correlates and Limitations  
In the integration of automated screening systems within EHRs, various bioethical and social/psychological considerations arise. This section addresses key ethical concerns surrounding privacy, informed consent, accuracy, equity, psychological impact, patient autonomy, trust in healthcare providers, and societal implications. During this stage in our research, we first addressed ethical correlates of the system. * Privacy and Confidentiality: Implementing this kind of system raises concerns about patient privacy and the security of medical data. Safeguarding patient confidentiality and ensuring data protection are paramount. One of the reasons for implementing the system in SF was the security of the platform. SF security refers to the measures and protocols put in place to protect data and ensure the privacy, integrity, and availability of information within the SF platform. Salesforce employs a multi-layered approach to security, incorporating various features and functionalities to safeguard data from unauthorized access, breaches, and other threats. Some key aspects of Salesforce security include: \(\bigcirc\) User Authentication and Access Control: SF provides robust authentication mechanisms, such as username/password, multi-factor authentication (MFA), and single sign-on (SSO), to verify user identities. Access controls, including role-based access control (RBAC) and permission sets, enable administrators to define and enforce granular access permissions based on user roles and responsibilities. \(\bigcirc\) Data Encryption: SF encrypts data both at rest and in transit to protect it from unauthorized access. Encryption ensures that sensitive information remains confidential even if accessed by unauthorized parties. Figure 12: Automatic classification module for ocular pathologies. Network Security: SF employs network security measures, such as firewalls, intrusion detection and prevention systems (IDPS), and distributed denial-of-service (DDoS) protection, to safeguard its infrastructure and prevent unauthorized access or attacks. Application Security: SF follows secure coding practices and regularly conducts security assessments and audits to identify and address vulnerabilities in its applications. Features like SF Shield provide additional security controls, such as event monitoring, data loss prevention (DLP), and encryption of sensitive data within Salesforce. Compliance and Governance: SF adheres to industry standards and regulatory requirements, such as GDPR, HIPAA, and SOC 2, to ensure compliance with data protection and privacy regulations. The platform also offers features like audit trails, compliance dashboards, and security certifications to help organizations demonstrate compliance and governance. Threat Detection and Monitoring: SF continuously monitors its platform for suspicious activities, unauthorized access attempts, and other security threats. Automated alerts, security logs, and real-time monitoring tools enable administrators to detect and respond to security incidents promptly. Secure Development Lifecycle: SF follows a secure development lifecycle (SDLC), incorporating security best practices into every stage of the software development process. This approach helps minimize security vulnerabilities and ensures that security is prioritized from the initial design phase through deployment and maintenance. Informed Consent: Patients should be adequately informed about the use of automated screening systems during routine check-ups. Transparent communication regarding data collection, storage, and usage is essential to respect patients' autonomy and decision-making. We developed and included forms like GDPR and Consent that the patients would be asked to sign before any medical procedures. Accuracy and Reliability: Ethical considerations include ensuring the accuracy and reliability of automated screening systems to minimize the risk of false positives or false negatives, which could lead to unnecessary anxiety or missed diagnoses.