Heeding humanity in an age of electronic health records: Heidegger, Levinas, and Healthcare

Abstract

The American Recovery and Reinvestment Act of 2009 (ARRA) required healthcare providers in the United States to adopt and demonstrate meaningful use of electronic health records (EHRs) by January 1, 2014. In many ways, EHRs mark a notable improvement over paper medical records as they are more easily accessible and allow for electronic searching and sharing of medical history. However, as EHRs have become mandated by ARRA, many nurses now rely upon computers far more heavily during nurse-patient interactions, thereby decreasing the level of direct interpersonal communication between the two. There is evidence that eye contact between nurses and patients positively affects patient satisfaction. Above and beyond the issue of patient satisfaction is the more basic ethical issue of respecting the patient as a person. The author argues that the templates used in electronic health systems have the possibility of eroding the respect for humanity that is the hallmark of nurse-patient relationships, as signalled by the American Nurses Association's first principle in their Code of Ethics. Using concepts from philosophers Martin Heidegger and Emmanuel Levinas, the author provides guidance as to what an ethical interaction between nurse and patient should look like in an age of EHRs.

Examination and diagnosis of electronic patient records and their associated ethics: a scoping literature review

“…In addition, EPR technology may leave less room for human interaction and interpretation. The standardised structure of EPRs may limit documentation of individual patient nuances and narrow information captured by HCPs about their patients [32,[149][150][151][152]. As a result, the patient may be seen as a series of data points rather than a human [82,130,153,154].…”

“…As a result, the patient may be seen as a series of data points rather than a human [82,130,153,154]. Furthermore, the EPR computer is sometimes seen as a third party that distracts from the intimacy of the doctor-patient relationship [51,63,83,149].…”

“…The articles almost exclusively discuss the relationship between patient and healthcare provider [43,53,82,83,87,94,127,138,148,149,155]. In contrast, duties to safeguard this relationship and promote trust and transparency is distributed among a range of stakeholders and processes: designers or developers of the EPR technology [60,126], institutional oversight [53,147], educational institutions [155], organisational processes [82,126], healthcare providers [43,83,94,127,141,148,149], policymakers [21,44,87,142], healthcare management [54] and dynamic consent models that improve patients' trust in how data is used [73].…”

To dwell within: Bridging the theory–practice gap

“…The majority of his most productive work was accomplished during and immediately following the Second World War. Although Martin Heidegger remains somewhat controversial due to his involvement with the Nazi party in Germany during the Second World War, his principal contributions to philosophy were centred on the realities of life and being (Mackey, ; Rentmeester, ). He asked questions on what it means to “be” in this time and space.…”

A call for feedback on postoperative care: Do we need an automated tool?

“…In person, follow-up and feedback provides human interaction between care givers and patients and results in greater patient satisfaction. 5 One wonders if rather than turning to an automated system, we should instead design a curriculum and work pattern that permits and insists on direct patient feedback.…”