The Ethical Implications of Personal Health Monitoring

Mittelstadt, Brent

doi:10.4018/ijt.2014070104

Cited by 40 publications

(43 citation statements)

References 91 publications

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“…This puts the emphasis on the broader relational autonomy, which centres on action rather than decision 13 (Owens and Cribb 2017). Accounts of relational autonomy recognise that acting is more complicated than deciding (Owens and Cribb 2017), not least because it takes place within the 'health habitus', where the types of online health information that people interact with, the ways that they interpret it, and the options that they have to act on it (Lewis 2006) (Mittelstadt et al 2014) are all constrained by a variety of socio-economic factors that affect some groups more than others (de Freitas and Martin 2015).…”

Section: Doomed To Failmentioning

confidence: 99%

The Limits of Empowerment: How to Reframe the Role of mHealth Tools in the Healthcare Ecosystem

Morley

Floridi

2019

Sci Eng Ethics

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This article highlights the limitations of the tendency to frame health-and wellbeing-related digital tools (mHealth technologies) as empowering devices, especially as they play an increasingly important role in the National Health Service (NHS) in the UK. It argues that mHealth technologies should instead be framed as digital companions. This shift from empowerment to companionship is advocated by showing the conceptual, ethical, and methodological issues challenging the narrative of empowerment, and by arguing that such challenges, as well as the risk of medical paternalism, can be overcome by focusing on the potential for mHealth tools to mediate the relationship between recipients of clinical advice and givers of clinical advice, in ways that allow for contextual flexibility in the balance between patiency and agency. The article concludes by stressing that reframing the narrative cannot be the only means for avoiding harm caused to the NHS as a healthcare system by the introduction of mHealth tools. Future discussion will be needed on the overarching role of responsible design.

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Section: Doomed To Failmentioning

confidence: 99%

The Limits of Empowerment: How to Reframe the Role of mHealth Tools in the Healthcare Ecosystem

Morley

Floridi

2019

Sci Eng Ethics

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“…At its best, H-IoT will help improve a user's health by generating data about the user's health and providing monitoring of conditions to supplement other forms of medical and social care. User's safety can, however, be placed at risk if H-IoT results in poorer quality of care, for instance if used as a replacement for human care [2]. In practice, this principle would require that H-IoT data to be used to inform the care of individual users and the advancement of medical knowledge and techniques.…”

Section: Non-maleficence and Beneficencementioning

confidence: 99%

“…Guideline 5 calls for design that supports the inclusion of medical professionals in H-IoT. A risk exists of using H-IoT with elderly users as a proxy for human care, or to shift care burdens from formal medical and social care institutions to the community and informal carers [2]. For the former, devices can be designed to periodically remind third party carers to visit the user in person to avoid social isolation.…”

Section: H-iot For Elderly Usersmentioning

confidence: 99%

“…The health-related Internet of Things (H-IoT) increasingly plays a key role in health management by providing real-time tele-monitoring of patients, testing of treatments, actuation of medical devices (e.g., medication dispensation), fitness and well-being monitoring, patient and carer alerts, among other applications [1]. Physiological parameters (e.g., heart rate, respiration, blood oxygen saturation, skin temperature, blood glucose, and blood chemistry) can be collected alongside behavioural parameters linked to health and well-being [2]. The health and behaviours of users can increasingly be digitised, recorded, stored and analysed, creating novel opportunities for clinical care and research [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Designing the Health-Related Internet of Things: Ethical Principles and Guidelines

Mittelstadt

2017

SSRN Journal

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The conjunction of wireless computing, ubiquitous Internet access, and the miniaturisation of sensors have opened the door for technological applications that can monitor health and well-being outside of formal healthcare systems. The health-related Internet of Things (H-IoT) increasingly plays a key role in health management by providing real-time tele-monitoring of patients, testing of treatments, actuation of medical devices, and fitness and well-being monitoring. Given its numerous applications and proposed benefits, adoption by medical and social care institutions and consumers may be rapid. However, a host of ethical concerns are also raised that must be addressed. The inherent sensitivity of health-related data being generated and latent risks of Internet-enabled devices pose serious challenges. Users, already in a vulnerable position as patients, face a seemingly impossible task to retain control over their data due to the scale, scope and complexity of systems that create, aggregate, and analyse personal health data. In response, the H-IoT must be designed to be technologically robust and scientifically reliable, while also remaining ethically responsible, trustworthy, and respectful of user rights and interests. To assist developers of the H-IoT, this paper describes nine principles and nine guidelines for ethical design of H-IoT devices and data protocols.

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“…Data security is thus regarded critical for protecting patient privacy [2]. There are multiple ways by which digital data may be accessed by third parties [13], not just for telehealth yet for the digital storage of any information, including data from monitoring devices mentioned previously for example.…”

Section: Introductionmentioning

confidence: 99%

Varsity medical ethics debate 2018: constant health monitoring - the advance of technology into healthcare

Gilmartin

Arbe-Barnes

Diamond

et al. 2018

Philos Ethics Humanit Med

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The 2018 Varsity Medical Ethics debate convened upon the motion: “This house believes that the constant monitoring of our health does more harm than good”. This annual debate between students from the Universities of Oxford and Cambridge is now in its tenth year. This year’s debate was hosted at the Oxford Union on 8th of February 2018, with Oxford winning for the Opposition, and was the catalyst for the collation and expansion of ideas in this paper.New technological devices have the potential to enhance patient autonomy, improve patient safety, simplify the management of chronic diseases, increase connectivity between patients and healthcare professionals and assist individuals to make lifestyle changes to improve their health. However, these are pitted against an encroachment of technology medicalising the individual and home, an exacerbation of health inequalities, a risk to the security of patient data, an alteration of the doctor-patient relationship dynamic and an infringement on individual self-identity. This paper will draw upon and develop these concepts, while contending arguments for and against constant health monitoring. This is not a review of medical devices and health monitoring, but a reflective development and more detailed elaboration of the main points highlighted in the 2018 Varsity Medical Ethics debate.

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The Ethical Implications of Personal Health Monitoring

Abstract: Personal Health Monitoring (PHM) uses electronic devices which monitor and record health

Cited by 40 publications

References 91 publications

The Limits of Empowerment: How to Reframe the Role of mHealth Tools in the Healthcare Ecosystem

The Limits of Empowerment: How to Reframe the Role of mHealth Tools in the Healthcare Ecosystem

Designing the Health-Related Internet of Things: Ethical Principles and Guidelines

Varsity medical ethics debate 2018: constant health monitoring - the advance of technology into healthcare

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