POTENTIAL ETHICAL ISSUES IN HEALTH
Introduction.
Research is an educational science of discovering the truth. As such, research involves a combination of reasoning and experiences, which in order to establish an appropriate conclusion, teaching, or assumption, it demands various approaches based on the collected data and the analysis to be used at that given time. Typically, these approaches could either be by use of qualitative research techniques, quantitative, or by extension, mixed research designs, and techniques. The latter research design integrates both qualitative and quantitative investigations to sustain a program of inquiry. Mixed research design aims at an integration of the design of collection and analysis that permit a more synergistic and complete utilization of data than both quantitative and qualitative research design. The paper examines an annotated bibliography of potential ethical issues in health care by providing researches that were based on the three sets of research designs, from which one can realize the circumstances that would demand either of the techniques.
Quantitative Research.
Ventola, C. L. (2014). Social media and health care professionals: benefits, risks, and best practices. Pharmacy and Therapeutics, 39(7), 491.
Lee Ventola examines the ethical issues that surround the use of social media by health care professionals. In a survey that he carries out to over 4,000 physicians by the use of a social media site QuantiaMD. He aims to find out potential risk factors such as the distribution of poor quality information, breaches to patient privacy, licensing or legal issues, damage to a professional image, and violation of personal-professional boundaries. Despite the many efforts that have been put in place by many healthcare institutions and healthcare professional organizations, he discovered that there could still be risks associated with the use of these technologies.
Lee surveys social networking platforms, including media sharing sites, blogs and microblogs, wikis, and virtual reality and gaming environments, given his belief that these tools may have an impact on how the healthcare professionals and systems are ethical. He postulates that it is due to an increasing number of social media users of all ages that there is a need to verify the potential benefits and risks of use for healthcare professionals. As such he researches on areas of Social Networking (Facebook, Myspace, Twitter and Google plus), professional networking (LinkedIn), media sharing (Flickr and YouTube), content production sites (Tumblr (blog) and microblogs (twitter)), knowledge and information aggregation (Wikipedia) as well as virtual reality and gaming environments (Second Life).
He finds out that 90% of physicians use some form of social media for personal activities, while 65% use them for professional reasons. Nearly one-third of these professionals have reported participation in social networking. And finally, he asserts that the use of social media both for personal and physicians is increasing that providing the significance of the study.
Ozair, F. F., Jamshed, N., Sharma, A., & Aggarwal, P. (2015). Ethical issues in electronic health records: A general overview. Perspectives in clinical research, 6(2), 73.
Ozaire and colleagues carry out a true experimental technique on the ethical issues that surround the use of EHR (electronic health records), which, according to them, are increasingly being implemented in many developing countries. They assert that though the use of electronic health records may improve the quality of healthcare and induce a cost-effective mode of record-keeping, it carries along with various ethical hazards with regard to the safety information in the system, thus posing a real challenge. Just like the research mentioned earlier conducted by Lee Ventola on social media, Ozair, and others base on potential security breaches that may lead to ethical issues.
In that regard, they propose an encrypted password as a probable option. However, they go further in proposing various solutions to various ethical risks associated with healthcare records that could elicit ethical challenges. In their research, they identify potential groups that could be associated with access to health records that could otherwise result in scenarios of privacy breaches and other unethical activities. They identify insurance companies, the legal representatives who may have access to the records in situations of mental instability of patients, etc., and authorized hospital staff.
They establish from their survey and analyses that most of the privacy breaches occur under the consent of the authorities as compared to those that result from security breaches by intruders. In their research that constituted 2,100 health workers within a period of six months; they contend that it is by use of strong protection and encryption methods as well as expertizing the physicians, technology professionals, administrative personnel, patients, and ethicists that the best ways to enhance the privacy of medical records can be enhanced. They promulgate multiple strategies such as teamwork, leadership, flexibility, and adaptability in finding solutions to ethical issues surrounding medical records. They advocate for quality, safe, efficient, and effective health care delivery electronic systems.
Qualitative Research.
Snelgrove, J. W., Jasudavisius, A. M., Rowe, B. W., Head, E. M., & Bauer, G. R. (2012). “Completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients. BMC health services research, 12(1), 110.
Snelgrove and colleagues employ qualitative research techniques to explore the ethical issues that surround members of the transgender community in their access barriers to healthcare. They focus on establishing physician perceptions of transgender patients serving as barriers to healthcare provision. They employ the use of semi-structured interviews to seize the progression of ideas regarding the barriers caused by physicians whenever they offer healthcare services to transgender patients. They majored in qualitative data, which were then transcribed verbatim and analyzed with a substantiated emergent theory approach.
In their study, they interview a total of thirteen physicians and ten transgender individuals. From their analysis, the group out five themes, diagnosing vs. pathologizing transgender patients, accessing resources, medical knowledge deficits, determinants of health systems, and transition-related ethics of medical care.
They conclude the study that physicians do maintain a perception of the transgender that bars proper care to transgender patients and privacy of their condition. They posit that these barriers are multifactorial. They assert that failure to recognize and accommodate such individuals with adversities within sex-segregated healthcare systems leads to health policy that is efficient and unethical.
Wang, Y., Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126, 3-13.
Wang, Kung, and Byrd employ the use of case studies to examine the content analysis of twenty-six big data analytics capabilities in search of their benefits and ethical issues presented through such. They focus on exploring historical developments, component functionality, and the architectural designs of big data analytics techniques in the healthcare industry. From their study, they identify five capabilities of big data. These capabilities that they focus on analyzing include decision support capabilities, analytical capability for patterns of care, predictive capability, unstructured data analytical capability, and traceability.
In their case analysis on these analytical tools, they embed and map the benefits of big data in aspects of IT infrastructure, managerial and strategic areas, organizational, and operational aspects to the resultant potential ethical issues. They also provide guidelines and strategies that could be adopted to ensure an ethically viable data analytical tool effectively supports healthcare services, and what to consider in adopting an analytical data technology in healthcare.
As such, they found that with the current technological advancement in healthcare, there is a great need for ensuring that every tool, particularly data analytic technology tool, adhere to ethical standards and seeks to formulate more effective data-driven analytics that poses to be potential benefits to the healthcare industry.
Mixed Research Designs.
Galanakis, E., Jansen, A., Lopalco, P. L., & Giesecke, J. (2013). Ethics of mandatory vaccination for healthcare workers. Eurosurveillance, 18(45), 20627.
With regard to an increased risk of health care workers contracting infections and transmitting the infections to patients and colleagues, Galanakis and others found it necessary to employ a mixed research design to identify potential ethical issues that surround this kind of likelihood. They explore concurrent study designs in trying to find fill the gap between the desired level of vaccination and realities that raise the question of whether voluntary uptake needs to be replaced with mandatory vaccination given the current low immunization rates, particularly among the healthcare workers. They do survey out that even in transmissible diseases such as pertussis, influenza, hepatitis B, and measles, immunization rates have become low, and thus if all these factors and situations would necessitate mandatory vaccination.
The underlying principle that these scholars explore to find out is whether mandatory vaccination of such transmissible infection is ethical. However, they rely much on the support of the mandatory vaccination posing it to be ethical given the emerging pandemics and outbreaks that need rapid adoption of this strategy. They integrate their study design with an exploration of case study qualitative technique in the search for a ‘conscientious objector’ that might be based on to introduce this system as they explore the historical mandatory smallpox vaccination in the United States and the United Kingdom.
In their evaluation of whether voluntary vaccination has failed and thereby need to be replaced with mandatory one, they conclude that mandatory vaccination will turn out ethical provided the benefits outweigh the potential harm to patients and healthcare workers. They suggest that fair rules and exemptions have to be defined in the process to enhance an ethical process.
Clark, J. L. (2013). Should humanitarian hearing healthcare providers be concerned about ethical practices? Part one: Need for continued engagement. The Hearing Journal, 66(5).
In an article written to The Hearing Journal, Clerk explores a mixed research design to ascertain the ethical practices employed by the Humanitarian Healthcare providers. She asks if there is a need for continued engagement. First, she explores the ethical desires of healthcare workers to provide healthcare services to those patients that would not otherwise access. Providing health services to disabled individuals who might need the support of cochlear implants for the hearing disables, surgeries for different levels of disabilities, and so forth.
She employs the use of negotiations with the humanitarian team and the ministry of health to identify any provisions that would otherwise promote this form of ethical considerations, especially for those who might not access extra primary medical care. Would it be ethical to provide them with such help that would otherwise be laid normal to those who would afford it?
She finds It is by the guidance of detailed accountability within a healthcare professional’s licensing jurisdiction to ascertain what is ethical, legal, and professional. She acknowledges that ethical and legal acceptable behaviors of the healthcare workers are defined through federal or state laws with the codes and regulations that maintain professional licensing that would determine the ethicality of any healthcare service and accepted standards to be employed.
Reference
Ventola, C. L. (2014). Social media and health care professionals: benefits, risks, and best practices. Pharmacy and Therapeutics, 39(7), 491.
Ozair, F. F., Jamshed, N., Sharma, A., & Aggarwal, P. (2015). Ethical issues in electronic health records: A general overview. Perspectives in clinical research, 6(2), 73.
Snelgrove, J. W., Jasudavisius, A. M., Rowe, B. W., Head, E. M., & Bauer, G. R. (2012). “Completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients. BMC health services research, 12(1), 110.
Wang, Y., Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126, 3-13.
Galanakis, E., Jansen, A., Lopalco, P. L., & Giesecke, J. (2013). Ethics of mandatory vaccination for healthcare workers. Eurosurveillance, 18(45), 20627.
Clark, J. L. (2013). Should humanitarian hearing healthcare providers be concerned about ethical practices? Part one: Need for continued engagement. The Hearing Journal, 66(5).
Drost, E.A. (2011). Validity and reliability in social science research. Education Research and Perspectives, 38 (1), 105-124.