Ethics in Design and Implementation of Technologies for Workplace Health Promotion: A Call for Discussion

Abstract

Aim: This study aims to initiate discussion on the ethical issues surrounding the development and implementation of technologies for workplace health promotion. We believe this is a neglected topic and such a complex field of study that we cannot come up with solutions easily or quickly. Therefore, this study is the starting point of a discussion about the ethics of and the need for policies around technologies for workplace health promotion.Method: Based on a literature review, the present study outlines current knowledge of ethical issues in research, development, and implementation of technologies in the workplace. Specifically, the focus is on two ethical issues that play an important role in the worker–employer relation: privacy and autonomy.Application: Two cases indicative for a multidisciplinary project aimed at developing and evaluating sensor and intervention technologies that contribute to keeping ageing workers healthy and effectively employable are explored. A context-specific approach of ethics is used to investigate ethical issues during the development and implementation of sensor and intervention technologies. It is a holistic approach toward the diverse field of participants and stakeholders, and the diversity in perceptions of relevant values, depending on their respective professional languages.Discussion: The results show how protecting the privacy and autonomy of workers cannot be seen as stand-alone issues, but, rather, there is interplay between these values, the work context, and the responsibilities of workers and employers. Consequently, technologies in this research project are designed to improve worker conscientious autonomy, while concurrently creating balance between privacy and health, and assigning responsibilities to appropriate stakeholders.Conclusion: Focusing on a contextual conceptualisation of the ethical principles in the design and implementation of digital health technologies helps to avoid compartmentalization, out-of-context generalisation, and neglect of identifying responsibilities. Although it is a long reiterative process in which all stakeholders need to be included in order to assess all ethical issues sufficiently, this process is crucial to achieving the intended goal of a technology. Having laid out the landscape and problems of ethics around technologies for workplace health promotion, we believe policies and standards, and a very overdue discussion about these, are needed.

Sync fast and solve things—best practices for responsible digital health

“…There appears to be considerable scope to provide more technological guidance, and concrete examples of incorporating principles into technology development. Indeed, a growing body of literature offers and reflects on responsible design for digital health research 49 , interventions 50 – 52 , and technology development 11 .…”

The ethical challenges of personalized digital health

“…and support the patient in managing their health status (e.g., drug alerts, warnings, physical activity alerts, diet suggestions, etc.) This represents the overall "Virtual PHI repository" (17), in which personal data are not limited to those generated when the individual is a "patient" but also when she/he is still healthy. Clinical data in the electronic health record (EHR) are part of personal data managed within healthcare information systems.…”

“…In the long run, the data generated and collected within a pHealth system will be relevant not only at the personal but also at the population level, in the light of "precision public health" (1). This complexity allows the transition from the simple definition of a pHealth digital system to a pHealth "ecosystem" (17), in which the common goal of all stakeholders is the patient. Solving this challenge requires the ontological representation of the business system and its domains involved, and this especially holds for policies and ethical challenges in transformed health ecosystems (41).…”

Digital workplace health promotion: a pilot study during the SARS-CoV-2 pandemic in Germany

“…For further studies, we suggest specifying regarding the type of digital intervention and investigating which trainings employees see a need for. As raised by the respondents and in research (Roossien et al, 2021), ethical and privacy issues need to be observed in the design. This is especially relevant in the context of protecting users and their interests (Lupton, 2015).…”

“…Based on the current literature (Kwasnicka et al ., 2022), we define DWHP as the use of digital means and tools to create and deliver health interventions for employees. This includes digital health applications, for example, for smartphones, activity trackers and sensors used for automated feedback on health behaviour (Roossien et al ., 2021), digitally providing health information for employees, using digital platform for all parts of the WHP-cycle, covering need assessment, intervention and evaluation (Walter et al ., 2019), or providing WHP activities as videos (Oppermann and Dierks, 2023), via streaming or as recordings.…”