The Ethics of Mobile Health Technology

2017 ◽  
Vol 41 (S1) ◽  
pp. S39-S39
Author(s):  
S. Galderisi ◽  
F. Caputo
Keyword(s):  
Health Equity ◽  
Mobile Health ◽  
New Technologies ◽  
Ethical Issues ◽  
Professional Associations ◽  
Health Technology ◽  
Ethical Guidelines ◽  
High Quality ◽  
Quality Healthcare ◽  
Health Technologies

IntroductionMobile health (m-health) technology has been growing rapidly in the last decades. The use of this technology represents an advantage, especially for reaching patients who otherwise would have no access to healthcare. However, many ethical issues arise from the use of m-health. Health equity, privacy policies, adequate informed consent and a competent, safe and high quality healthcare need to be guaranteed; professional standards and quality of doctor-patient relationship in the digital setting should not be lower than those set for in-person practice.AimsTo assess advantages and threats that may arise from the wide use of m-health technologies, in order to guarantee the application of the best medical practices, resulting in the highest quality healthcare.MethodsA literature search has been conducted to highlight the most pressing ethical issues emerging from the spreading of m-health technologies.ResultsFew ethical guidelines on the appropriate use of m-health have been developed to help clinicians adopt a professional conduct within digital settings. They focus on the need for professional associations to define ethical guidelines and for physicians to take care of their education and online behavior when using m-health technologies.ConclusionsThe rapid spreading of m-health technologies urges us to evaluate all ethical issues related to its use. It would be advisable to produce an ethical code for the use of these new technologies, to guarantee health equity, privacy protection, high quality doctor-patient relationships and to ensure that m-health is not chosen over traditional care for merely economic purposes.Disclosure of interestSG received honoraria or Advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter. All other authors have declared.

The neuroethical future of wearable and mobile health technology

2017 ◽  
Author(s):  
Karola V. Kreitmair ◽  
Mildred K. Cho
Keyword(s):  
Mobile Health ◽  
Ethical Issues ◽  
Health Technology ◽  
The Self ◽  
Ethical Challenges ◽  
Mobile Health Technology ◽  
Healthcare Settings ◽  
Healthcare It ◽  
Mobile Mental Health ◽  
Privacy And Confidentiality

Wearable and mobile health technology is becoming increasingly pervasive, both in professional healthcare settings and with individual consumers. This chapter delineates the various functionalities of this technology and identifies its different purposes. It then addresses the ethical challenges that this pervasiveness poses in the areas of accuracy and reliability of the technology, privacy and confidentiality of data, consent, and the democratization of healthcare. It also looks at mobile mental health apps as a case study to elucidate the discussion of ethical issues. Finally, the chapter turns to the question of how this technology and the associated “quantification of the self” affect traditional modes of epistemic access to and phenomenological conceptions of the self.

OP101 Do We Need To Extend Health Technology Assessment To Health Enhancement Assessment?

2017 ◽  
Vol 33 (S1) ◽  
pp. 46-46
Author(s):  
Bjørn Hofmann
Keyword(s):  
Health Care ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Cognitive Abilities ◽  
Literature Search ◽  
Ethical Issues ◽  
Health Technology ◽  
Health Technologies ◽  
Health And Wellbeing ◽  
Wide Range

INTRODUCTION:Several health technologies used for therapy can also be used for health enhancement. Drugs stimulating cognitive abilities are but one example. Health Technology Assessment (HTA) has not been developed for assessing enhancements. This raises the question of how HTA should address the blurred distinction between therapy and enhancement. Should we (i) carve out a distinction between therapy and enhancement and limit HTA to therapy, (ii) use HTA for both therapy and enhancement (with some modifications), or (iii) should we develop a separate health enhancement assessment (HEA)?METHODS:A literature search of the medical, philosophical, and bioethical literature was conducted for debates, arguments, and suggested solutions to the issue of therapy versus enhancement.RESULTS:The same improvement in health may be therapeutic in one patient, but an enhancement in another. Moreover, both therapy and enhancement share the same goal: increased health and wellbeing. A wide range of arguments try to establish a difference between therapy and enhancement. They refer to naturalness, rehabilitation, normality, species-typical functioning/potential, disease, sustainability, and responsibility. On closer scrutiny few of these arguments do the job in bolstering the therapy-enhancement distinction. We already use a wide range of means to extend human abilities. Moreover, the therapy-enhancement distinction raises a wide range of ethical issues that are relevant for the assessment of a number of emerging health technologies.CONCLUSIONS:Existing HTA methodology can address a wide range of non-therapeutic health enhancements. However, a series of broader issues related to the goal of health care and responsibility for altering human evolution may not be addressed within traditional HTA frameworks. Specific HEAs may therefore be helpful.

scholarly journals Information on ethical issues in health technology assessment: How and where to find them

2010 ◽  
Vol 26 (4) ◽  
pp. 441-449 ◽  
Author(s):  
Sigrid Droste ◽  
Charalabos-Markos Dintsios ◽  
Andreas Gerber
Keyword(s):  
Information Retrieval ◽  
Information Seeking ◽  
Ethical Issues ◽  
Research Question ◽  
Methodological Approach ◽  
Health Technology ◽  
Search Strategies ◽  
Assessment Process ◽  
Bibliographic Databases ◽  
Health Technologies

Background: Comprehensive health technology assessments (HTAs) include thorough reflections on ethical issues associated with health technologies, their use, and value-based decisions in the assessment process. As methods of information retrieval for effectiveness assessments are not applicable to information retrieval on ethical issues, a specific methodological approach is necessary.Objectives: In the absence of existing adapted methods, our objective was to develop a methodological approach for the systematic retrieval of information on ethical issues related to health technologies.Method and Results: A literature search was conducted to verify the non-existence of published comprehensive methodological approaches for the information retrieval on ethical issues for HTAs, and resulted in no hits. We, therefore, developed a step-by-step workflow following the workflow of information retrieval for effectiveness assessments: Step 1: Translation of the search question using the PICO scheme and additional components. Step 2: Concept building by modeling and linking search components. Step 3: Identification of synonyms in all relevant languages. Step 4: Selection of relevant information sources. Step 5: Design of search strategies for bibliographic databases. Step 6: Execution of search strategies and information seeking, including hand-searching. Step 7: Saving of retrieval results and standardized reporting of the process and results. Step 8: Final quality check and calculation of precision and recall.Conclusions: Systematic searching for information on ethical issues related to health technologies can be performed following the common retrieval workflow for effectiveness assessments, but should be performed separately applying adapted procedures and search terms on ethical issues relevant to the research question.

Ethics in Couple and Family Psychotherapy

2020 ◽  
Author(s):  
Marcel Schaer ◽  
Célia Steinlin
Keyword(s):  
Family Therapy ◽  
Couple Therapy ◽  
Ethical Issues ◽  
Conflicts Of Interest ◽  
Medical Model ◽  
Professional Associations ◽  
Ethical Guidelines ◽  
Couple And Family Therapy ◽  
Ethical Problems ◽  
The Enlightenment

In couple and family therapy, the focus is on relationships, interactions, and the dynamics within the system. The therapist should strive to maintain a balanced and trustful relationship with all members of the system, and at the same time do justice to their individual wishes and perspectives. Couples and families usually present themselves with conflicts of interest that they have failed to resolve. Dealing with conflicts of interest is therefore an important element of couple and family therapy. The existing ethical guidelines, defined by psychological professional associations and medical ethics experts, are not specific enough at representing the complexities which family and couple therapists are confronted with. As an alternative to the ethical guidelines, Beauchamp and Childress (2008) have worked out general ethical principles: respect for autonomy, nonmaleficence, beneficence, and justice. In this chapter, a number of ethical problems in couple and family therapy are discussed against the backdrop of these principles. Problems in family and couple therapy can be addressed based on the question who of the system members carries more blame and who can execute more control. Four models of help, i.e., the medical model, the compensatory model, the enlightenment model, and the moral model, are presented with regard to this question. Finally, it is argued that ethical issues in couple and family therapy are relational and context-dependent. They must therefore be resolved in the encounter with each other.

HEALTH TECHNOLOGY ASSESSMENT IN IRELAND

2000 ◽  
Vol 16 (2) ◽  
pp. 449-458 ◽  
Author(s):  
Frank Ahern ◽  
Nessa O'Doherty
Keyword(s):  
Health Services ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
New Technologies ◽  
New Technology ◽  
Health Technology ◽  
Maximum Efficiency ◽  
Hospital System ◽  
Health Technologies ◽  
New Public Health

Ireland's health system is primarily funded from general taxation and is publicly provided, although private health care retains a considerable role. It is a unique structure, a mixture of universal health service free at the point of consumption and a fee-based private system where individuals subscribe to private health insurance that covers some of their medical expenses. The recent history of the Irish health services saw consolidation of existing services and an expansion into new areas to adapt to changing practices and needs. There has also been a drive to extract maximum efficiency so as to maintain the volume and quality of patient services at a time of very tight financial constraints. Introduction of new health technologies continued to accelerate. New technologies tended to spread rapidly before systematic appraisal of their costs and benefits. When the state is involved in funding the public hospital system, acceptance of new technology is a matter for discussion between agencies and the Department of Health and Children. Decisions about spending annual “development funding” have generally not been based on careful assessment of proposals for new technology. In 1995, a healthcare reform put new Public Health Departments in Health Boards in a prime position in Ireland's health services organization. These departments now emphasize evidence-based medicine. While Ireland does not have a national health technology assessment (HTA) program, there are plans to form an advisory group on HTA in 1998. HTA is seen as a significant element of future health policy in Ireland.

scholarly journals A Survey Research on the Willingness of Gynecologists to Employ Mobile Health Applications

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Malik Bader Alazzam ◽  
Ahmad Tawfig Al-Radaideh ◽  
Raed Ahmed Alhamarnah ◽  
Fawaz Alassery ◽  
Fahima Hajjej ◽  
...  
Keyword(s):  
Mobile Health ◽  
Private Information ◽  
Health Technology ◽  
Analytical Investigation ◽  
Medical Professionals ◽  
Mobile Health Technology ◽  
Health Technologies ◽  
Mobile Health Applications ◽  
Gynecological Care ◽  
Willingness To Use

In gynecological care, mHealth (mobile health) technology may play an important role. Medical professionals’ willingness to use this technology is the key to its acceptance. Most doctors utilize mobile health technology; however, there is still room for improvement in the use of mHealth. Gynecologists were asked to participate in this research to see how open they were to use mobile health technologies. In this descriptive-analytical investigation, the researchers determined the average scores for each variable. The overall mean for preparedness to embrace mobile medical technology is 1.8 out of 2, as shown in Table 1. When it came to their desire to embrace mobile health technology, doctors’ years of experience correlated negatively with their age. According to our findings, the amount of interest in mobile health technology is high. Patients’ private information must be protected throughout the usage of this technology though. Mobile health technology may effectively reach patients in remote areas, but it is not a substitute for face-to-face encounters with medical professionals.

When Is the ‘right’ Time to Initiate an Assessment of a Health Technology

1998 ◽  
Vol 14 (2) ◽  
pp. 372-386 ◽  
Author(s):  
Graham Mowatt ◽  
D. Jane Bower ◽  
John A. Brebner ◽  
John A. Cairns ◽  
Adrian M. Grant ◽  
...  
Keyword(s):  
Life Cycle ◽  
Critical Point ◽  
New Technologies ◽  
Early Stage ◽  
Health Technology ◽  
Limited Resources ◽  
Optimal Timing ◽  
Precautionary Approach ◽  
Health Technologies ◽  
The Right

AbstractThere is currently no generally accepted formula for the optimal timing of health technology assessments (HTAs). This paper presents some of the relevant issues and then reviews the existing literature on timing of HTAs. It finds that the literature that specifically addresses these issues is limited. There is a consensus that HTAs should be initiated at an early stage of the development of a new health technology, and repeated during the life cycle of the technology. However, the questions of reliably identifying new technologies at an early stage in their development and of deciding on a detectable critical point for starting evaluation are not resolved. It is proposed that a system of categorization and prioritization of health technologies should be developed to allow decisions to be made as to when a strongly precautionary approach is required and how the limited resources available for HTA could be optimally deployed.

scholarly journals Understanding and Preventing Health Concerns About Emerging Mobile Health Technologies (Preprint)

2019 ◽  
Author(s):  
Frank T Materia ◽  
Kate Faasse ◽  
Joshua M Smyth
Keyword(s):  
Public Health ◽  
Mobile Health ◽  
New Technologies ◽  
Clinical Intervention ◽  
Well Being ◽  
Physical Symptoms ◽  
Nocebo Effect ◽  
Health Concerns ◽  
Health Technologies ◽  
Mhealth Technology

UNSTRUCTURED New technologies and innovations have often improved population well-being and societal function; however, these are also often initially accompanied by worry and fear. In some cases, such worries can impede, or even prevent entirely, the adoption of the technology. Mobile health (mHealth), a discipline broadly focused on employing ambulatory technologies to improve the affordability, reach, and effectiveness of health promotion and clinical intervention approaches, offers new innovations and opportunities. Despite emerging evidence supporting mHealth efficacy (eg, for improving health outcomes), some individuals have concerns about mHealth technology that may impede scalability, efficacy, and, ultimately, the public health benefits of mHealth. We present a review and conceptual framework to examine these issues, focusing on three overarching themes: biophysiological, psychological, and societal concerns. There are features of mHealth that lead to worries about the potential negative effects on an individual’s health (eg, due to exposure to electromagnetic or radio waves), despite evidence supporting the safety of these technologies. When present, such beliefs can lead to worry that gives rise to the experience of unpleasant and concerning physical symptoms—the nocebo effect. This may represent an important implementational barrier because of apprehension toward beneficial mHealth products (or features thereof, such as wireless charging, wearable or implantable sensors, etc) and may also have broader ramifications (eg, leading to economic, governmental, and legislative actions). In addition to reviewing evidence on these points, we provide a broad three-step model of implementation research in mHealth that focuses on understanding and preventing health concerns to facilitate the safe and effective scalability of mHealth (and that may be generalizable and applied to similar technologies): (1) evaluating and better discerning public perceptions and misperceptions (and how these may differ between populations), (2) developing theory-based public health communication strategies regarding the safety of mHealth, and (3) disseminating this messaging using evidence-based methods. Collectively, these steps converge on reviewing evidence regarding the potential role of worry and nocebo in mHealth and providing a model for understanding and changing attitudes and preventing unfounded negative perceptions related to mHealth technology.

DEVELOPMENTS IN VALUE FRAMEWORKS TO INFORM THE ALLOCATION OF HEALTHCARE RESOURCES

2017 ◽  
Vol 33 (2) ◽  
pp. 323-329 ◽  
Author(s):  
Wija Oortwijn ◽  
Laura Sampietro-Colom ◽  
Fay Habens
Keyword(s):  
Ethical Issues ◽  
Stakeholder Involvement ◽  
Health Technology ◽  
Health Technologies ◽  
The Core ◽  
Access To Health ◽  
Different Types ◽  
Core Components ◽  
Additional Value ◽  
Policy Forum

Background:In recent years, there has been a surge in the development of frameworks to assess the value of different types of health technologies to inform healthcare resource allocation. The reasons for, and the potential of, these value frameworks were discussed during the 2017 Health Technology Assessment International (HTAi) Policy Forum Meeting.Methods:This study reflects the discussion, drawing on presentations from invited experts and Policy Forum members, as well as a background paper.Results:The reasons given for a proliferation of value frameworks included: rising healthcare costs; more complex health technology; perceived disconnect between price and value in some cases; changes in societal values; the need for inclusion of additional considerations, such as ethical issues; and greater empowerment of clinicians and patients in defining and using value frameworks. Many Policy Forum participants recommended learning from existing frameworks. Furthermore, there was a desire to agree on the core components of value frameworks, defining the additional value elements as necessary and considering how they might be measured and used in practice. Furthermore, adherence to the principles of transparency, predictability, broad stakeholder involvement, and accountability were widely supported, along with being forward looking, explicit, and consistent across decisions.Conclusions:Value frameworks continue to evolve with significant implications for global incentives for innovation and access to health technologies. There is a role for the HTA community to address some of the key areas discussed during the meeting, such as defining the core components for assessing the value of a health technology.

scholarly journals Examining the Ethical Implications of Health Care Technology Described in US and Swedish PhD Dissertations: Protocol for a Scoping Review (Preprint)

2019 ◽  
Author(s):  
Jens M Nygren ◽  
Hans-Peter de Ruiter
Keyword(s):  
Ethics Education ◽  
New Technologies ◽  
Ethical Issues ◽  
Research Question ◽  
The United States ◽  
Unintended Effects ◽  
Ethical Perspective ◽  
Health Technologies ◽  
Ethical Implications ◽  
Scoping Reviews

BACKGROUND The development of new biomedical technologies is accelerating at an unprecedented speed. These new technologies will undoubtedly bring solutions to long-standing problems and health conditions. However, they will likely also have unintended effects or ethical implications accompanying them. It may be presumed that the research behind new technologies has been evaluated from an ethical perspective; however, the evidence that this has been done is scant. OBJECTIVE This study aims to understand whether and in what manner PhD dissertations focused on health technologies describe actual or possible ethical issues resulting from their research. METHODS The purpose of scoping reviews is to map a topic in the literature comprehensively and systematically to identify gaps in the literature or identify key evidence. The search strategy for this protocol will include electronic databases (eg, ProQuest, PubMed, Diva, SwePub, and LIBRIS). Searches will be limited to PhD dissertations published in the United States and Sweden in the last 10 years. The study will be mapped in 5 stages: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) retrieving and charting the data, and (5) collating, summarizing, and reporting the results. RESULTS The findings of this study will indicate if and how researchers, PhD students, and their supervisors are considering ethics in their studies, including both research ethics and the ethical implications of their work. The findings can guide researchers in determining gaps and shortcomings in current doctoral education and offer a foundation to adjusting doctoral research education. CONCLUSIONS In a society where technology and research are advancing at speeds unknown to us before, we need to find new and more efficient ways to consider ethical issues and address them in a timely manner. This study will offer an understanding of how ethics is currently being integrated into US and Swedish PhD dissertations and inform the future direction of ethics education at a doctoral level. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/14157

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