This is a text written by Jon Berg <jon.berg|a|turtlemeat.com> spring 2005 in the Computer Science course Medical Informatics at Tromsø University, Norway.
Current and future possibilities of Medical Informatics
7. New Ethical challenges
Introduction of automatic methods in health care
New technology provides the health professionals with tools that are more efficient and easy to use. For example diagnostic tools that lets a diagnostic applications do part large part of the diagnostic process that previously had to be done by a human. Even as such technology gets introduced the human is still important. Even as more and more of the work that was done by a person can be replaced by automated systems, the human plays an important role. A person is capable of reasoning further than what is written in the algorithms of the systems. Decisions that have to be made for a patient often have consequences that reach outside of the just treatment of a disease. Concerns for a poorer quality of the diagnostic process could be raised when the diagnostic work gets performed by a computer. The purpose these systems have always been that they should be a tool for the health professional. It was never the intention to replace the human in the process. It is not likely that the doctor will be replaced when it comes to making the final decision. The doctor will be liable for the decisions he makes, which a computer program never can be. Even as these tools gets better and they can perform more complicated diagnostic which before was only possible for a human it is likely that the human never will be replaced. The role today and in the future for diagnostic applications are to act as a second opinion. It cold also raise concern since these tools would let the health worker be more effective. Even if the health professional is able to work faster does not mean that the quality becomes lower. It is likely that it becomes more accurate. It would in fact become poorer quality if it the health professional was expected to cover more work, but without any helper tools.
Even if the health professional that is working with the patient have the final responsibility of the decisions made for a patient, the decision he makes are funded on the work of others. This means that even if such tools make it easier to do the work it does not mean that the person can be any less educated. The person using the tool must be able to recognize if the tool make errors, such as in the clinical support systems making a wrong diagnosis. It must always be known when using these tools that they are meant only for reference and a second opinion and not for the results from these tools to be a full worthy diagnostic.
The data collected from patients that undergo medical treatments can also have applications in other settings. For example in research, it is useful to have a pool of data to extract finding from to use in experiments and analysis. Personal information is often not relevant, and the data can be cleared of any data that can be used for clear identifications of person. Most patients would not have any problems with such use since the research will benefit everybody. Pooled data could also be used in a less favorable way for future patients. It would be possible to do analysis on critical ill patients based on how much a treatment would cost and compare it versus the outcomes. The results of such analysis could be that patients that would fit certain criteria that where unfavorable would be denied treatment. This could be seen as unethical since a persons chance of becoming healthy or surviving comes down to pre-calculated chances and the price tag.
Data security in medical informatics
It is important to uphold traditional standards of privacy and confidentiality even when new technology is introduced. The information technology makes it easier for health care workers to get the access to the information they need when they need it. Balancing access and privacy and security is important. Medical data is sensitive data that the patients want to keep private. Most patients today have great faith in how a sensitive data is handled. When patients are confident that the information they share are kept confidential they are also more willing to give out information that will be used in their treatment.
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