Technology and Ethics in Healthcare: Balancing Progress and Principles

Technology and Ethics in Health Care 1
Technology and Ethics in Health Care
Amanda K. Romano-Kwan
California State University of Long Beach

TECHNOLOGYAND ETHICS IN HEALTH CARE 2
Abstract
Advancements in health care technology have revolutionized the medical industry for many
years. The evolving industry has become heavily dependent on these new technologies, and
requires that hospitals and other medical centers adjust to these changes in order to meet the
quality demands and needs of patients and consumers, as well as other state and federal
regulatory requirements. Health information technology, along with medical technology, aims to
advance patient care and improve the medical field through the constant delivery of safe, quality
care. Although these changes in technology aim to benefit the overall health of the population,
there are a series of ethical issues that follow each new technological development. The health
care field operates within a series of procedures, principles, and standards that make various
aspects of medical technology morally and ethically questionable. This paper will discuss the
technological advances in health care and the potential pitfalls that may occur without the proper,
ethical use of technology. It will also outline the basic moral obligations required of all health
care professionals.

Technology and Ethics in Health Care
Medical and health information technology has become increasingly prevalent within all
health care organizations. Advancements in technology over time have continued to evolve the
medical field into the system that is used today. The growth of these resources has allowed the
improved treatment of medical ailments and diseases across the world at a more efficient level.
Nevertheless, each new development has the potential to negate various core principles of the
health care industry. The medical field has become “dependent on technological developments to
ensure organizational success” (Morrison & Furlong, 2014) due to its need to meet the high
demands of quality care. It is important for health care providers to understand and properly
evaluate the potential ethical implications of their use of medical and health information
technology in order to maintain a high standard of care.
Ethics
Every individual has their own set of beliefs, morals, and values that they uphold in their
daily lives. The term ‘ethics’ usually refers to moral principles and “matters of social policy
involving issues of morality” (American Medical Association, 1996). Therefore, medical ethics
is the application of ethical principles in the medical field. Each health care professional has the
moral duty and obligation to comply with the proper behavior in order to maintain the best
possible relationship with their patients. The guidelines provided for medical professionals
include core principles designed to put the patient first. Autonomy is one of the most important
basic moral obligations involved in health care. Autonomy focuses on the individual and their
right to make their own decisions. Beneficence, or the duty to operate within the patient’s best
interests, is another fundamental idea in the principles of medical ethics. Unfortunately, the
medical field is still a business entity and largely focuses on the monetary profit that health care

provides. Therefore, it is important for medical professionals to remain ethical and overlook
greed so as to avoid creating barriers to accessibility and affordability. Non-maleficence is the
commitment to do no harm. The health and well-being of all people is the primary goal of health
care services, making non-maleficence an integral principle of medical ethics. Other important
qualities of ethical practices in health care include justice and honesty. Justice relates to the
fairness and equality of all patients. Issues involving justice usually revolve around concerns
about the lack of resources and decisions of priority treatment. The truth is essential in health
care; without honest communication between a doctor and their patient, the medical procedures
may not be what is best for the individual. Furthermore, all medical professionals have the moral
obligation to respect all cultures and religious backgrounds of their patients. The failure to
comply with these core principles translates to unethical conduct, and usually results in censure,
suspension, or expulsion from medical practices. It is important to note, however, that no ethical
principle is more right or wrong than the other. Each principle can be weighed and judged
differently depending on each situation. The values outlined do not provide answers to unethical
dilemmas, but rather provide a framework for understanding conflicts and give insight on how to
handle difficult situations.
Technology
Medical technology aims to advance patient care, increase the efficiency of the health
care industry, and further the quality of medical care. The advancement of medical equipment,
products, and procedures allows patients a wider variety of treatment options to better suit their
individual needs. The development of these new resources require the quality, efficiency, and
safety of the research and implementation process of each new invention. Several regulations and
license requirements are in place to ensure patient safety and test the overall effectiveness of the

technology. Unfortunately, past innovations show that there is a lack of focus on medical ethics
and the intended outcomes or benefits of new technology.
Research and development have been important parts in the advancement of medical
technology. Regrettably, the increasing dependence on technology allows researchers to focus on
outcomes for only those that directly benefit from the study. It is important that the methods of
research remain ethical throughout the entire study. One well-known example of unethical
medical research was the Tuskegee Syphilis Study, which involved a study on humans. The
ethical issues involved in this study revolve around the lack of patient autonomy and informed
consent. The research participants included 400 African American males split evenly into either a
control or experimental group. The experimental group was purposely exposed to active syphilis,
and then told that the medication they were receiving was treatment for a rare, deadly blood
disease. In return for their participation, the men were given food, medical care, and burial
insurance as compensation (Tuskegee University, 2016). The study lacked autonomy due to the
failure of the researchers to properly obtain informed consent from their participants. There are
four elements needed in order to gain informed consent: the patient must be competent, meaning
that they understand the treatment involved in the study, including potential outcomes and side
effects; the patient must be volunteering and given the opportunity to say no, allowing them the
opportunity to decide on their participation based on their own terms and free from outside
influences; the patient must have full disclosure or knowledge of all features of the research,
including legal and ethical aspects; and the patient must give their authorization, or agreement, to
the research and understand that they are part of a scientific study (Morrison & Furlong, 2014).
Unfortunately, none of the four elements were met in this study, as none were addressed or
followed before the participants entered the study. Furthermore, offering compensation that was

specifically appealing to the disadvantaged African American population was highly unethical.
Scientific progress is enlightening and beneficial, but it is vital for researchers to adhere to the
outlined ethical guidelines.
Individuals must analyze the new technological innovations that are created every day
and the potential future benefits or consequences that it may have. The development of a new
medical technology may have a myriad of positive effects that help improve the efficiency and
accessibility of the health care system. However, no new scientific finding becomes widely
accepted or integrated into every day society without previous scrutinization and criticism from
fellow research experts in the field. The same critique is applied to new advancements of medical
technology. For instance, the recent innovations in the field of synthetic biology raise a series of
ethical concerns and mixed opinions. Synthetic biology is a genetics-related science that allows
scientists to replace natural genetic material with synthetic, or human-made, genetic material.
The synthetic copied material has the ability to self-replicate, opening doors for the substitution
of raw materials in place of genetic materials inside living organisms. This breakthrough in
science is largely accredited to rapid advancements in technologies relating to DNA synthesis
and molecular biology (Newson, 2015). This field of research allows for the potential creation of
“organisms with novel or enhanced characteristics or traits” (Guttman, 2011), which can lead to
new discoveries that may greatly benefit the medical field. However, the creation of genetic
materials from natural resources is still a new and developing field of research, and therefore the
practices involved undergo much speculation. The Presidential Commission for the Study of
Bioethical Issues, under special request from President Barack Obama in 2010, investigated the
field and determined the ethical boundaries in order to maximize the potential benefits for the
public and minimize the risks (U.S. Department of Health and Human Services, 2010). President

Obama recognized the potential of the developing field, but was also aware of the ethical
challenges presented and the unknown consequences that society may face without proper
evaluation. In response to the President, the Commission identified five ethical principles to be
used in the consideration of the social implications of synthetic biology: public beneficence, to
maximize public benefits and minimize public harm; responsible stewardship, to ensure
consideration to those who are unable to represent themselves for the benefits of the research,
and to the environment for future generations; intellectual freedom, which allows individuals to
responsibly use their studies in morally accountable ways through the implementation of periodic
assessments and regulations; democratic deliberation, to ensure representation from all groups of
society and allow for respectful debate and active participation for all citizens; and justice and
fairness to guarantee the even distribution of benefits and risks associated with the study across
society (Presidential Commission for the Study of Bioethical Issues, 2010). These ethical
principles provided a guideline to analyze synthetic biology and ensure that its discoveries are
used for society’s best interests. It can also be applied to other fields of science and research in
the medical field. Medical technology should be easily accessible to all members of society and
used for public benefit with minimized risks. The research performed must follow state and
federal regulations, as well as the moral guidelines outlined to guarantee the ethical treatment of
all participants. Individuals are obligated to understand the ethical concerns that arise with each
new unknown innovation and critically consider the future applications and consequences that
can occur.
Health information technology refers to the use of computer systems and software in the
medical field to provide quality care through the use of electronic medical records. This includes
all computer-assisted management-of-care products and other database platforms (Morrison &

Furlong, 2014). The use of health information technology has become increasingly prevalent
with the evolving digital age. Although the use of such technology is not mandatory, medical
hardware and software increases productivity, improves quality outcomes, and makes reporting
mechanisms much easier for medical professionals at a much quicker rate. Due to the rapid
development of new technologies, health information technology can become outdated or
obsolete within a few months, making the adaptation to this digital change difficult to
implement. Electronic health records (EHRs), or certified technology used to exchange health
information, have become one of the most controversial topics in the health care industry. The
transfer from paper records to electronic medical records offers a wide selection of benefits
through improved legibility and communication of records, verifiability of documents, and the
standardization of data. Just like all other aspects of medical technology, the ethical concern is
the use of EHRs and how they can most benefit the patients. The American Recovery and
Reinvestment Act (ARRA) of 2009 aimed to accelerate the implementation of EHRs among
health care providers. The Health Information Technology for Economic and Clinical Health
(HITECH) Act was a part of the ARRA, and provided a wider range of privacy and security
enforcements, as well as insisted on the ‘meaningful use’ of EHRs amongst medical
professionals (Leyva & Leyva , 2016). Meaningful use is defined as the use of EHR technology
to: improve quality, safety, efficiency, and reduce health disparities; to engage patients and
family; to improve care coordination, and population and public health; and to maintain privacy
and security of patient health information” (National Coordinator for Health Information
Technology, 2015). This is to ensure the proper demonstration of their applicable use as
mandated by the ARRA of 2009. The pressure to EHR technology was strong, however this push
to digitalize medical records and information raises ethical concerns regarding beneficence—not

for the patients, but for medical organizations. The HITECH Act provided a series of financial
incentives to encourage health care organizations to implement EHR technology within a
specific timeframe. However, the application of this technology comes with much risk, and
without the safe and diligent transfer from paper to computer, the success of EHR technology
becomes seriously flawed. Promoting timelines on the incorporation of EHRs to medical
providers threatens the quality of care to patients. Small and medium-sized healthcare
organizations may not have the financial resources to properly implement EHR technology
within the dictated timeline. The confidentiality and accuracy of patient data is extremely
valuable, and without the careful transfer of this data, various medical and ethical issues arise.
Furthermore, the proper education on the use and function of new EHR technology must be
provided for all stakeholders, including the medical providers and the patients. Health care
organizations have a moral obligation to act in the patient’s best interests and maintain their well-
being. By letting financial concerns influence the decisions and implementation of electronic
health records, health care organizations fail to maintain the highest standard of quality care (de
Ruiter, Liaschenko, & Angus, 2016).
It is important to note, however, that EHRs are not required, and many providers have
made the decision to opt-out and remain using paper medical records regardless of the financial
outcomes. The decision to reject electronic documentation is not without concern, as people
question the ability of medical providers to match the efficiency of EHRs in accessing,
organizing, documenting, and reporting on patient care quality. Patient information becomes less
accessible and more likely to be overlooked, which can lead to the prescription of incorrect or
contradicting medications. The illegibility of physician handwriting is also a major concern, as a
misunderstanding of orders can lead to serious dosing errors or other medical complications. The

principle of non-maleficence is called into question, as patients may be at risk for unnecessary
harm due to the mentioned errors. Negligence on behalf of the provider may also be considered,
as the benefits of EHRs have been proven to increase the quality of care, and the decision to
forego the digital transition can be viewed as the denial for better care for their patients (de
Ruiter, Liaschenko, & Angus, 2016).
Despite the usefulness of electronic medical records, the use of this technology can still
have unintended ethical consequences. Patient confidentiality is of upmost importance in the
medical field. Laws have been created to secure more patient protection rights. The Health
Information Portability and Accountability Act (HIPAA) outlines national standards to “protect
individual’s medical records and other personal health information and applies to…health care
providers that conduct certain health care transactions electronically… [And] also gives patients’
rights over their health information, including rights to examine and obtain a copy of their health
records, and to request corrections” (U.S. Department of Health and Human Services, 2016). The
American Medical Association created a standard Code of Medical Ethics which states that “the
information disclosed to a physician or clinician during the course of the patient-physician
relationship is confidential to the utmost degree” (American Medical Association, 2016). This
assurance of confidentiality allows the patient to safely disclose their personal medical
information to ensure that they receive the care best suited to their individual needs. Electronic
health records largely increase the accessibility of this patient information due to its ability to be
retrieved through several information technology resources, such as laptops and smart phones.
Although this data is protected through a series of security measures, the increased risk is large
enough to constitute cautious observation of EHRs. Breaches of data have occurred several
times, allowing the inappropriate and illegal access to private health information of multiple

individuals. Patients should not have to be concerned about the security of their medical
information. The medical history of an individual is highly sensitive and should be limited to
those who need to know of their medical needs. It is the duty of all health care organizations to
uphold the highest possible security precautions, as well as to educate all medical professionals
of the HIPAA requirements for patient protection and confidentiality. Additionally, the transfer
from paper to digital does not negate the possibility of error, as technological mistakes can be
made and easily multiplied throughout the systems database. Other pitfalls of EHRs include the
potential to “misrepresent service, render authorship ambiguous, and divert attention from the
patient” (Cheshire, 2013). The careless use of electronic medical records can lead to numerous
legal complications and ethical concerns, therefore it is vital for health care providers to remain
vigilant in their efforts to use EHRs responsibly and for the benefits of the patient. There are
many debates on the use electronic health records, however this constant battle of pros and cons
can be found with every new technological development in the medical field. It is impossible to
weigh the concerns of one group over another, as each perspective offers valuable insight to the
potential benefits and consequences that EHRs offer. The best solution is to act foremost with the
needs of the patient in mind and to provide the highest possible quality care, whilst adhering to
the suggested ethical guidelines for proper use and implementation. Consequently, health care
organizations “should welcome electronic medical record systems that add value and safety to
clinical care as long as they do not displace the individual responsibility of the ethical physician”
(Cheshire, 2013).
Modern medical ethics demands the proper use of developing technology across the
world. Advancements in technological resources have improved the medical industry by
countless bounds for hundreds of years and have allowed for the improved treatment of patients

at a more effective level. The overall benefits that medical and health information technology
provide easily overshadow the disadvantages, however the use of these technologies have not
been without the disregard of various moral principles. History teaches an invaluable lesson in
the appropriate treatment and use of medical technology, and it is crucial for health care
providers to learn from these past mistakes in order to properly respect basic medical values and
treat patients with respect. Those in the medical profession have an obligation to remain honest
and to preserve the ideals of patient autonomy, beneficence, non-maleficence, and justice, as well
as maintaining the proper respect for all individuals and cultures. Following a system of core
values such as trustworthiness, fairness, responsibility, and respect can provide guidance for the
correct and ethical use of technological advances that are not accompanied with a set of moral
guidelines specific to their use. Medical and health information technology is the future of
medical care, and health care organizations must analyze and confront the ethical concerns that
arise before, during, and after the implementation of advanced technology in order to provide
patients with the best possible quality of care.

References
American Medical Association. (1996, June). AMA's Code of Medical Ethics. Retrieved April 12,
2016, from American Medical Association: http://www.ama-assn.org/ama/pub/physician-
resources/medical-ethics/code-medical-ethics.page?
American Medical Association. (2016). AMA's Code of Medical Ethics. Retrieved April 5, 2016,
from American Medical Association: http://www.ama-assn.org/ama/pub/physician-
resources/medical-ethics/code-medical-ethics.page
Cheshire, W. P. (2013, Fall). Can Electronic Medical Records Make Physicians More Ethical?
Ethics & Medicine: An International Journal of Bioethics, 30(3), 135 - 141. Retrieved
April 17, 2016, from
http://web.b.ebscohost.com.ezproxy.library.csulb.edu/ehost/pdfviewer/pdfviewer?sid=81f
4fbb1-03ed-4f86-8ec6-b1c893509496%40sessionmgr115&vid=1&hid=124
de Ruiter, H.-P., Liaschenko, J., & Angus, J. (2016, January). Problems with the Electronic
Health Record. Nursing Philosophy, 17(1), 49 - 58. Retrieved April 22, 2016, from
http://web.b.ebscohost.com.ezproxy.library.csulb.edu/ehost/detail/detail?sid=3a26cd2d-
2385-4fe3-a8e8-
2e8740be5a48%40sessionmgr105&vid=0&hid=124&bdata=JnNpdGU9ZWhvc3QtbGl2
ZQ%3d%3d#AN=112217832&db=a9h
Guttman, A. (2011, July). The Ethics of Synthetic Biology: Guiding Principles for Emerging
Technologies. Hastings Center Report, 41(4), 17 - 22. Retrieved April 15, 2016, from
http://web.b.ebscohost.com.ezproxy.library.csulb.edu/ehost/pdfviewer/pdfviewer?sid=d1
2f2fbc-82b6-421c-9850-9be17c6b4b41%40sessionmgr106&vid=10&hid=124

Leyva, C., & Leyva , D. (2016). HITECH Act Summary. (I. 3Lions Publishing, Producer)
Retrieved April 5, 2016, from HIPAA Survival Guide:
http://www.hipaasurvivalguide.com/hitech-act-summary.php
Morrison, E. E., & Furlong, B. (2014). Health Care Ethics: Critical Issues for the 21st Century
(Third ed.). Burlington, Massachusetts: Jones & Bartlett Learning.
National Coordinator for Health Information Technology. (2015, February 6). Meaningful Use
Definition and Ojbectives. Retrieved April 17, 2016, from HealthIT.gov:
https://www.healthit.gov/providers-professionals/meaningful-use-definition-objectives
Newson, A. J. (2015, January). Synthetic Biology: Ethics, Exceptionalism and Expectations.
Macquarie Law Journal, 15, 45 - 58. Retrieved April 12, 2016, from
http://web.b.ebscohost.com.ezproxy.library.csulb.edu/ehost/pdfviewer/pdfviewer?sid=81c
887c7-cc8a-4cda-8359-df0a4387bde0%40sessionmgr114&vid=1&hid=124
Presidential Commission for the Study of Bioethical Issues. (2010). New Directions: The Ethics
of Synthetic Biology and Emerging Technologies. Washington D.C.: Presidential
Commission for the Study of Bioethical Issues. Retrieved April 17, 2-16, from
http://bioethics.gov/sites/default/files/PCSBI-Synthetic-Biology-Report-12.16.10_0.pdf
Tuskegee University. (2016). About the USPHS Syphilis Study. Retrieved April 4, 2016, from
Tuskegee University:
http://www.tuskegee.edu/about_us/centers_of_excellence/bioethics_center/about_the_usp
hs_syphilis_study.aspx
U.S. Department of Health and Human Services. (2010, May). New Directions: The Ethics of
Synthetic Biology and Emerging Technologies. Retrieved April 22, 2016, from

Presidential Commission for the Study of Bioethical Issues:
http://bioethics.gov/synthetic-biology-report
U.S. Department of Health and Human Services. (2016). The HIPAA Privacy Rule. Retrieved
April 22, 2016, from HHS.gov: http://www.hhs.gov/hipaa/for-professionals/privacy/

Technology and Ethics in Healthcare: Balancing Progress and Principles

Recommandé

Recommandé

Contenu connexe

Tendances

Tendances (20)

En vedette

En vedette (7)

Similaire à Technology and Ethics in Healthcare: Balancing Progress and Principles

Similaire à Technology and Ethics in Healthcare: Balancing Progress and Principles (20)

Technology and Ethics in Healthcare: Balancing Progress and Principles