Thesis: Ethical Issues in Health Care Information Technology

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Ethical Issues in Health Care Information Technology

The purpose of this work in writing is to increase the understanding of Knowledge Management ethics and to identify, examine and analyze concepts, principles and practices related to KM ethics and health care information technology. This work will additionally examine appropriate methods in responsibly addressing ethical dilemmas and promoting ethical standards and practices in the use of health care information technology.

Health care services have been transformed over the past two decades by the increasing use of information technology however, ethical issues have arisen in regards to health care IT generating many studies as well as animated and serious debates relating to Ethical Issues and which have resulted in the proposal of practical solutions and guidelines for health care professions. President Obama's proposal for conversion of the record-keeping system from that of paper medical records to an electronic system have driven the debate along with the ethical issues of topic.

The work of Gould and Younkins (1992) entitled: "Guidelines Help Mangers Deal with Ethical Issues -- Healthcare Financial Mangers" states that ethical issues exist in regards to financial management techniques in the field of healthcare. This work, written approximately 16 years ago highlighted the significant time that financial management required and that ethical problems arising from wrongly coded expenses and patient diagnosis information had triggered ethics violations. While these types of problems have been mitigated due to information technology in the health care practice other ethical issues have arisen. Information technology applications are well-serving efficiency and effectiveness factors in today's medical field and health care practice however the use of these types of technologies are creating new and unheard of ethical concerns for today's practitioners.

I. ETHICAL CONCERNS RELATED TO INFORMATION TECHNOLOGY (IT) AND INFORMATION COMMUNICATION TECHNOLOGY (ICT) DEVICES

The work of Marckmann and Goodman (2006) states that not only has computer-based information and communication technologies served in transforming health care delivery but as well it has transformed "the conception and scientific understanding of the human body and the diseases that afflict it." (p.1) Marckmann and Goodman (2006) additionally state that medical informatics has experienced a quick evolution and in fact as quick as "any science in history, paralleling and relying on extraordinary advances in information collection, storage, analysis and transmission. Indeed, like sciences and technologies that precede it -- biochemistry, microbiology, genetics and cell biology, pharmacology and so on -- medical informatics is changing the standard of care. It is no longer fanciful to consider whether it might be blameworthy for a physician or an allied health professional to fail to use intelligent machines or their accoutrements in clinical practice and research." (2006, p.3)

Marckmann and Goodman (2006) relate that information and computer technology in the field of medicine not only stores and processes data on patients but as well may be used in creating virtual realities which are used in teaching and training and the example stated is that of Janne Lahtiranta and Kimppa in the use of virtual reality in the form of "anthropomorphized, human-life artefacts..." (p.4)

It is reported by the Institute of Medicine (IOM) in the work entitle: "To Err is Human: Building a Safer Health System" that approximately "...between 44,000 and 98,000 people die in hospital each year as a result of medical errors that could have been prevented." (p.4 cited in: Marckmann and Goodman, 2006) In fact the Institute of Medicine states that the use of simulation is best practice in "teaching institutions...for training novice practitioners." (Marckmann and Goodman, 2006, p.4) It is stated however, that the medical students "...should be aware of these limitations and enjoy sufficient opportunity to interact with the complexity of real-world patients. Computer-based simulation can be a valuable supplement, but should never be a substitute of conventional bedside teaching." (Marckmann and Goodman, 2006, p.4)

"One ethical challenge that is presented by information technology in the medical field is that which is related to moral problems "...created by the use of constructive technologies. Modern imaging technologies like magnetic resonance imaging (MRI), positron emission tomography (PET) or functional MRI provide new and -- supposedly -- realistic insights into the human body. However, these images are highly constructive artefacts that result from an extremely complicated model driven algorithms, computations and visualizations. These epistemic observations become ethically relevant, if the images are used without reflection of their production process. Instead of depicting the world as it is, the images are heavily loaded with interpretations and create new meanings for "health, " "disease," "normality," and "gender." Developing standardized atlases of the brain also elicits ethical issues given the plasticity and inter -- and intra-individual variability of the cerebral structure and functioning." (Marckmann and Goodman, 2006, p.4)

Because of these images being realistic in their appearance these images which are rendered by computer applications "create the illusory impression that certain differences between groups and populations are biologically fixed within the human brain. This can promote stereotypes and false dichotomies that are embedded in the seemingly "objective" results of scientific imaging techniques." (Marckmann and Goodman, 2006, p.4)

II. ICT IMPLANTS AND DEEP BRAIN STIMULATION DEVICES

Additionally it is related that there are ethical concerns relating to information and communication technologies since these are innovatively used in computer integration processes, modeling and transmission of patient data and in the form of implants. Medical science and health care practice has entered a new dimension in this area of health care practice and questions which arise are those related to the ethical aspects of "...neuronal motor prostheses. Advances in the neuro-sciences and in micro system technology provide the potential to connect computer-systems with the human brain via brain-computer interfaces. This might offer new therapeutic perspectives especially for paralyzed patients. The goal is to bridge the interrupted nerve fibers with micro-technical devices and connect the cortex to an artificial limb or -- even better -- with the paralyzed limb of the patient. On the one hand, brain-computer interfaces raise general ethical issues related to the protection of human subjects and the limits of a man-machine-integration. On the other, neuronal motor prostheses raise ethical issues that can be attributed to technological components themselves. Will the implanted electrodes of the input component that registers the cortical field potentials alter the patient's personality traits in an unacceptable way?" (Marckmann and Goodman, 2006, p.4)

Therefore, ethical concerns require that the following questions be addressed:

(1) Who bears responsibility for actions of the artificial limb that result from an indissoluble interaction between the patient's brain and the decoding algorithm?

(2) Will the wireless output component allow unwanted external control of interference?

(3) Who bears responsibility for actions of the artificial limb that result from an indissoluble interaction between the patient's brain and the decoding algorithm?

(4) Will the (probably) wireless output component allow unwanted external control or interference? (Marckmann and Goodman, 2006, p. 4)

Marckmann and Goodman relates that the patient-risk must be "balanced against the benefits of restored limb function." (2006, p. 5)

It is discussed by Elizabeth Hildt that ICT implants have another application in the neurosciences that present ethical concerns because this process involves implantation of electrodes in the brain which presents a possibility of the treatment of tremors in patients with Parkinson's disease and other such neurostimulation treatments possibility resulting in effects to the individual's personality and character traits. The specific concerns include whether the patient will experience changes that are irreversible and it is concludes that "...deep brain stimulation should be restricted to severe disorders with a well-known pathophysiological basis for which there are no other less invasive treatments with comparable effectiveness." (Marckmann and Goodman, 2006, p.5)

III. ETHICAL CONSIDERATIONS IN THE AREA OF GENETICS

The work of Nagenbor and Faddagh examine the use which is appropriate in the area of genetic information and relate that ethical issues in this area stem from the use of computer technology in processing specific genetic information and that such applications are critically important in diagnosing hereditary diseases and in the selection of "effective therapeutic interventions according to the specific genotype of the patient." (Marckmann and Goodman, 2006, p.4) The problem which arises is that there are other entities that have a keen interest in such information relating to genetics and there are questions and concerns related to access, ownership, and control of this type of information.

While some issues relating to use of genetic information have been addressed such as the Genetic Information Nondiscrimination Act (GINA) which effectively bars insurance companies and employers in the United States from "discriminating on the basis of information derived from genetic tests..." (The Genome Project, 2008, p.1) There are still areas of ethical concern relating to information technology applications in the health care practice that have not been so addressed through legislation.

SUMMARY & CONCLUSION

As stated previously the purpose of this work has to been to increase the understanding of Knowledge Management ethics and to identify, examine and analyze concepts, principles and practices related to KM ethics and health care information technology. As noted in the work of… [END OF PREVIEW]

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Ethical Issues in Health Care Information Technology.  (2009, June 7).  Retrieved September 20, 2019, from https://www.essaytown.com/subjects/paper/ethical-issues-health-care-information/3629125

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