Ethical aspects of digital health from a justice point of view

Abstract

Digital health is transforming healthcare systems worldwide. It promises benefits for population health but might also lead to health inequities. From an ethical perspective, it is hence much needed to adopt a fair approach. This article aims at outlining chances and challenges from an ethical perspective, focusing especially on the dimension of justice—a value, which has been described as the core value for public health. Analysed through the lenses of a standard approach for health justice—Norman Daniels’ account of just health and accountability for reasonableness—most recent and relevant literature was reviewed and challenges from a justice point of view were identified. Among them are challenges with regard to digital illiteracy, resulting inequities in access to healthcare, truthful information sharing to end users demanding fully informed consent, dignity and fairness in storage, access, sharing and ownership of data. All stakeholders involved bear responsibilities to shape digital health in an ethical and fair way. When all stakeholders, especially digital health providers and regulators, ensure that digital health interventions are designed and set up in an ethical and fair way and foster health equity for all population groups, there is a chance for this transformation resulting in a fair approach to digital health.

Does the purpose matter? A comparison of everyday information and communication technologies between eHealth use and general use as perceived by older adults with cognitive impairment

“…Health care providers are recommended to play an important role in providing support to those patients who have low eHealth literacy and thus need support in navigating among often-conflicting health information available on the Internet [59]. From an ethical perspective, it is crucial that all stakeholders, especially those delivering eHealth solutions, design interventions in an ethical and fair way, fostering health equity for all population groups and taking into account the needs of disadvantaged groups [20]. To end, for all of them left outside the digital society today and/or in the future, it is of great importance to create solutions making it possible for them to take advantage of the benefits of EICT solutions in society, including eHealth.…”

“…In parallel with an increasing and aging global population [17], there is a lack of health care professionals [18] generating substantial challenges in health care [19]. Digital solutions are transforming health care worldwide [20] and eHealth services and functions are emphasized to play a crucial role in solving these challenges [21][22][23]. The concept of eHealth has several definitions [24].…”

“…The table shows the 32 EICTs included in the S-ETUQ þ of which 16 EICTs are for eHealth use (nos. 1-16) and 16 EICTs for general use (nos [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]…”

The second information revolution: digitalization brings opportunities and concerns for public health

“…There is also scope for intentional discrimination 22 . The US investigative journalism organization ProPublica demonstrated that they could restrict advertisements on Facebook for attractive rental properties in New York to exclude African–Americans, Jews and anyone who had shown an interest in aids for disabled people 23 .…”

Moral distress and ethical decision-making of eldercare professionals involved in digital service transformation

“…Digital services in eldercare are rapidly becoming more common, which shows that technology affects human practices and experiences [20][21][22], and, therefore, ethical decision-making [23]. The digital transition in eldercare is already taking place and, as research publications on the ethics of digital care are still scarce, this article investigates how technology affects the ethical decision making of eldercare professionals and what, if anything, makes that decision making difficult [24].…”