SERIES: eHealth in primary care part 2: Exploring the ethical implications of its application in primary care practice
<p><strong>Background:</strong><br /> eHealth promises to increase self-management and personalised medicine and improve cost-effectiveness in primary care. Paired with these promises are ethical implications, as eHealth will affect patients’ and primary care professionals’ (...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Taylor and Francis
2019
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| _version_ | 1826259380311425024 |
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| author | Boers, SN Jongsma, KR Lucivero, F Aardoom, J Büchner, FL De Vries, M Honkoop, P Houwink, EJF Kasteleyn, MJ Meijer, E Pinnock, H Teichert, M Van Der Boog, P Van Luenen, S Van Der Kleij, RMJJ Chavannes, NH |
| author_facet | Boers, SN Jongsma, KR Lucivero, F Aardoom, J Büchner, FL De Vries, M Honkoop, P Houwink, EJF Kasteleyn, MJ Meijer, E Pinnock, H Teichert, M Van Der Boog, P Van Luenen, S Van Der Kleij, RMJJ Chavannes, NH |
| author_sort | Boers, SN |
| collection | OXFORD |
| description | <p><strong>Background:</strong><br />
eHealth promises to increase self-management and personalised medicine and improve cost-effectiveness in primary care. Paired with these promises are ethical implications, as eHealth will affect patients’ and primary care professionals’ (PCPs) experiences, values, norms, and relationships.</p><br />
<p><strong>Objectives:</strong><br />
We argue what ethical implications related to the impact of eHealth on four vital aspects of primary care could (and should) be anticipated.</p><br />
<p><strong>Discussion:</strong><br />
(1) EHealth influences dealing with predictive and diagnostic uncertainty. Machine-learning based clinical decision support systems offer (seemingly) objective, quantified, and personalised outcomes. However, they also introduce new loci of uncertainty and subjectivity. The decision-making process becomes opaque, and algorithms can be invalid, biased, or even discriminatory. This has implications for professional responsibilities and judgments, justice, autonomy, and trust. (2) EHealth affects the roles and responsibilities of patients because it can stimulate self-management and autonomy. However, autonomy can also be compromised, e.g. in cases of persuasive technologies and eHealth can increase existing health disparities. (3) The delegation of tasks to a network of technologies and stakeholders requires attention for responsibility gaps and new responsibilities. (4) The triangulate relationship: patient–eHealth–PCP requires a reconsideration of the role of human interaction and ‘humanness’ in primary care as well as of shaping Shared Decision Making.</p><br />
<p><strong>Conclusion:</strong><br />
Our analysis is an essential first step towards setting up a dedicated ethics research agenda that should be examined in parallel to the development and implementation of eHealth. The ultimate goal is to inspire the development of practice-specific ethical recommendations.</p> |
| first_indexed | 2024-03-06T18:48:56Z |
| format | Journal article |
| id | oxford-uuid:0f8240fc-2f31-4e15-8bdf-b624aba065a9 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:48:56Z |
| publishDate | 2019 |
| publisher | Taylor and Francis |
| record_format | dspace |
| spelling | oxford-uuid:0f8240fc-2f31-4e15-8bdf-b624aba065a92022-03-26T09:51:36ZSERIES: eHealth in primary care part 2: Exploring the ethical implications of its application in primary care practiceJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0f8240fc-2f31-4e15-8bdf-b624aba065a9EnglishSymplectic Elements at OxfordTaylor and Francis2019Boers, SNJongsma, KRLucivero, FAardoom, JBüchner, FLDe Vries, MHonkoop, PHouwink, EJFKasteleyn, MJMeijer, EPinnock, HTeichert, MVan Der Boog, PVan Luenen, SVan Der Kleij, RMJJChavannes, NH<p><strong>Background:</strong><br /> eHealth promises to increase self-management and personalised medicine and improve cost-effectiveness in primary care. Paired with these promises are ethical implications, as eHealth will affect patients’ and primary care professionals’ (PCPs) experiences, values, norms, and relationships.</p><br /> <p><strong>Objectives:</strong><br /> We argue what ethical implications related to the impact of eHealth on four vital aspects of primary care could (and should) be anticipated.</p><br /> <p><strong>Discussion:</strong><br /> (1) EHealth influences dealing with predictive and diagnostic uncertainty. Machine-learning based clinical decision support systems offer (seemingly) objective, quantified, and personalised outcomes. However, they also introduce new loci of uncertainty and subjectivity. The decision-making process becomes opaque, and algorithms can be invalid, biased, or even discriminatory. This has implications for professional responsibilities and judgments, justice, autonomy, and trust. (2) EHealth affects the roles and responsibilities of patients because it can stimulate self-management and autonomy. However, autonomy can also be compromised, e.g. in cases of persuasive technologies and eHealth can increase existing health disparities. (3) The delegation of tasks to a network of technologies and stakeholders requires attention for responsibility gaps and new responsibilities. (4) The triangulate relationship: patient–eHealth–PCP requires a reconsideration of the role of human interaction and ‘humanness’ in primary care as well as of shaping Shared Decision Making.</p><br /> <p><strong>Conclusion:</strong><br /> Our analysis is an essential first step towards setting up a dedicated ethics research agenda that should be examined in parallel to the development and implementation of eHealth. The ultimate goal is to inspire the development of practice-specific ethical recommendations.</p> |
| spellingShingle | Boers, SN Jongsma, KR Lucivero, F Aardoom, J Büchner, FL De Vries, M Honkoop, P Houwink, EJF Kasteleyn, MJ Meijer, E Pinnock, H Teichert, M Van Der Boog, P Van Luenen, S Van Der Kleij, RMJJ Chavannes, NH SERIES: eHealth in primary care part 2: Exploring the ethical implications of its application in primary care practice |
| title | SERIES: eHealth in primary care part 2: Exploring the ethical implications of its application in primary care practice |
| title_full | SERIES: eHealth in primary care part 2: Exploring the ethical implications of its application in primary care practice |
| title_fullStr | SERIES: eHealth in primary care part 2: Exploring the ethical implications of its application in primary care practice |
| title_full_unstemmed | SERIES: eHealth in primary care part 2: Exploring the ethical implications of its application in primary care practice |
| title_short | SERIES: eHealth in primary care part 2: Exploring the ethical implications of its application in primary care practice |
| title_sort | series ehealth in primary care part 2 exploring the ethical implications of its application in primary care practice |
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