Even the wisest of doctors are relying on scientific truths the errors of which will be recognized within a few years time.

The randomized, double-blind, placebo-controlled trial, about a half-century old, is reckoned to be the gold standard for acquiring evidence in medicine. Indeed, the randomized controlled trial (RCT) is the engine of evidence-based practice. But such trials are often either inapplicable or impossible, or they are in keen need of volunteers – both situations in which the Internet has been enlisted. Indeed, the use of computers and related tools to seek, gather, store, analyze, and share personal health information poses interesting and difficult ethical challenges, especially given advances in knowledge discovery in databases, in terms of the requirements of informed or valid consent, and facing the increased evidentiary burdens of contemporary practice. The stakes can be very high, indeed, when computers, consent, and confidentiality intersect as scientists try to develop early warning systems for bioterrorism.